Rustic River Homes

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9097H Issued in AZ

Legal business name

RUSTIC RIVER HOMES

Practice address

2124 E Firestone Dr
Chandler, AZ 85249-4634

Phone

(480) 244-8457

Fax

(480) 659-1076

NPI assigned

May 5, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Nathan Pleitner

Title

RN Manager

Phone

(480) 244-8457

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1689051062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 E FIRESTONE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852494634",
            "telephone_number": "480-244-8457",
            "fax_number": "480-659-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 E FIRESTONE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852494634",
            "telephone_number": "480-244-8457",
            "fax_number": "480-659-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSTIC RIVER HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "PLEITNER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "RN MANAGER",
        "authorized_official_telephone_number": "480-244-8457",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL9097H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "835207",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Michelle Rusk
• Daisy May Russell
• Janet Young Russell, M.D.
• Monet Russo
• Julia Russomanno, MC, LPC
• Kay Anne Rutledge, FNP-C
• Jennifer Ryalls, PTA
• Craig Ryan, CRNA
• Crisini Rae Ryan
• Erin Ryan, PMHNP-BC

• Assisted Living Facility in Chandler, AZ
• Providers in Chandler, 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 5, 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.

Verify at the official NPI Registry.