Active NPI
Golden Life Assisted Living Home-1
- Adult Care Home Facility
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- AL8880H
- Legal business name
- GOLDEN LIFE ASSISTED LIVING HOME-1
- Practice address
- 4113 W Hayward Ave
Phoenix, AZ 85051-5751 - Phone
- (602) 332-0780
- Fax
- (623) 399-8915
- NPI assigned
- Feb 27, 2015
- Last updated
- Feb 27, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rebecca Siddiqui
- Title
- Administrator
- Phone
- (602) 332-0780
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | AL8880H | AZ | Primary |
Addresses
Primary practice location
4113 W Hayward Ave
Phoenix, AZ 85051-5751
Mailing address
4113 W Hayward Ave
Phoenix, AZ 85051-5751
Phone (602) 332-0780
National Provider Directory
National Provider Directory- Tax ID family
- Az Advanced Care LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Adult Care Home Facility
- Phoenix, AZ
- NPI 1346645702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424995200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1424995200000",
"number": "1558753533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4113 W HAYWARD AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850515751",
"telephone_number": "602-332-0780",
"fax_number": "623-399-8915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4113 W HAYWARD AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850515751",
"telephone_number": "602-332-0780",
"fax_number": "623-399-8915"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOLDEN LIFE ASSISTED LIVING HOME-1",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-27",
"last_updated": "2015-02-27",
"status": "A",
"authorized_official_last_name": "SIDDIQUI",
"authorized_official_first_name": "REBECCA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "602-332-0780"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "AZ",
"license": "AL8880H",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.