Casa de Vida Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CASA DE VIDA LIVING LLC

Practice address

7036 W Parkway Dr
Phoenix, AZ 85043-6921

Phone

(602) 696-6249

NPI assigned

Jun 4, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Brent Lee Blunt, AL-MANAGER

Title

Ceo

Phone

(602) 696-6249

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1720602832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7036 W PARKWAY DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850436921",
            "telephone_number": "602-696-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7036 W PARKWAY DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850436921",
            "telephone_number": "602-696-6249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6713 N 41st Dr",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850191001",
            "country_code": "US",
            "telephone_number": "602-696-6249",
            "fax_number": "623-936-6833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CASA DE VIDA LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "BLUNT",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-696-6249",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "AL-MANAGER"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.