NPIMap

Organization Active NPI

Archie Hendricks Sr Skilled Nursing Facility

Doing business as Tohono O'odham Elder Assisted Living Residence

  • Assisted Living Facility
  • Sells, AZ
National Provider Identifier
1689914103
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ARCHIE HENDRICKS SR SKILLED NURSING FACILITY
Doing business as
Tohono O'odham Elder Assisted Living Residence
Practice address
Milepost 9, Federal Route 15
Sells, AZ 85634
Phone
(520) 585-5500
Fax
(520) 585-5500
NPI assigned
Feb 20, 2013
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
James Chaston
Title
Cfo/Business Office Manager
Phone
(520) 585-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

Milepost 9, Federal Route 15
Sells, AZ 85634

Mailing address

HC 1 Box 9100
Sells, AZ 85634-9744
Phone (520) 585-5500

Other names 1

  • Tohono O'odham Elder Assisted Living Residence Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Archie Hendricks Sr Skilled Nursing Facility3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1689914103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 9100",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "856349744",
            "telephone_number": "520-585-5500",
            "fax_number": "520-585-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MILEPOST 9, FEDERAL ROUTE 15",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "85634",
            "telephone_number": "520-585-5500",
            "fax_number": "520-585-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHIE HENDRICKS SR SKILLED NURSING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "CHASTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO/BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "520-585-5500"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tohono O'odham Elder Assisted Living Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sells, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.