Los Nino'S Day Care of Catalina LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9394H Issued in AZ

Legal business name

LOS NINO'S DAY CARE OF CATALINA LLC

Practice address

203 E Avenue I
San Manuel, AZ 85631-1357

Phone

(520) 909-3241

NPI assigned

May 15, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Patricia Ann Gonzales

Title

Owner

Phone

(520) 400-4217

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary & Pete's Assisted Living Doing business as

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

{
    "created_epoch": "1463270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463270400000",
    "number": "1679920136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74",
            "city": "SAN MANUEL",
            "state": "AZ",
            "postal_code": "856310074",
            "telephone_number": "520-909-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E AVENUE I",
            "city": "SAN MANUEL",
            "state": "AZ",
            "postal_code": "856311357",
            "telephone_number": "520-909-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS NINO'S DAY CARE OF CATALINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-15",
        "last_updated": "2016-05-15",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-400-4217",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL9394H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "004189",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary & Pete's Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Dawn Diaz, FNP-C
• Naomi Arlene Duffett, NP
• Anne Marie Fister, CCC-SLP
• Jacy Kathleen Godsey, APRN-CNP
• Debra Hill
• John Mahoney, RPH
• Mammoth-San Manuel Usd #8
• Boru Nale, M.D.
• Jane Ann Newman, PH.D.
• Gary Lee Reyes, PTA

• Assisted Living Facility in San Manuel, AZ
• Providers in San Manuel, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2016; 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.