Imperial Palace Assisted Living

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

IMPERIAL PALACE ASSISTED LIVING

Practice address

17225 W Gambit TRL
Surprise, AZ 85387-1128

Phone

(480) 395-3331

Fax

(480) 800-6510

NPI assigned

Aug 2, 2024

Organization subpart

No

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

Authorized official

Name

Jocelyn Jasper

Title

Owner-Manager

Phone

(480) 395-3331

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1730919135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17225 W GAMBIT TRL",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853871128",
            "telephone_number": "480-395-3331",
            "fax_number": "480-800-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17225 W GAMBIT TRL",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853871128",
            "telephone_number": "480-395-3331",
            "fax_number": "480-800-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL PALACE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "JASPER",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "OWNER-MANAGER",
        "authorized_official_telephone_number": "480-395-3331"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.