NPIMap

Organization Active NPI

Eagle Pass Senior Living LLC

  • Assisted Living Facility
  • Glendale, AZ
National Provider Identifier
1659936433
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EAGLE PASS SENIOR LIVING LLC
Doing business as
AMARSI ASSISTED LIVING
Practice address
5125 N 58TH Ave
Glendale, AZ 85301-7453
Phone
(623) 915-5720
Fax
(623) 931-8776
NPI assigned
May 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lee Johnson
Title
Treasurer
Phone
(208) 401-1369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

5125 N 58TH Ave
Glendale, AZ 85301-7453

Mailing address

5125 N 58TH Ave
Glendale, AZ 85301-7453
Phone (623) 915-5720

Other names 1

  • AMARSI ASSISTED LIVING Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1659936433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017453",
            "telephone_number": "623-915-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017453",
            "telephone_number": "623-915-5720",
            "fax_number": "623-931-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE PASS SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-07",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "208-401-1369"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMARSI ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AMARSI ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.