NPIMap

Organization Active NPI

24TH Street Healthcare Associates LLC

Doing business as Desert Terrace Healthcare Center

  • Skilled Nursing Facility
  • Phoenix, AZ
National Provider Identifier
1760477541
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
24TH STREET HEALTHCARE ASSOCIATES LLC
Doing business as
Desert Terrace Healthcare Center
Practice address
2509 N 24TH St
Phoenix, AZ 85008-1805
Phone
(602) 273-1347
Fax
(602) 273-6260
NPI assigned
Sep 16, 2005
Last updated
Feb 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Ms. Soon Burnam
Title
Authorized Agent
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X AZ Primary

Addresses

Primary practice location

2509 N 24TH St
Phoenix, AZ 85008-1805

Mailing address

2509 N 24TH St
Phoenix, AZ 85008-1805
Phone (602) 273-1347

Other identifiers 1

IdentifierTypeStateIssuer
688062MedicaidAZ

Other names 1

  • Desert Terrace Healthcare Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100126000533 AZ Part A Provider - Skilled Nursing Facility 7517874530 Practice locations: Phoenix, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760477541. Details of each certification follow.

Skilled nursing facility certification: CCN 035014

Legal name
24TH STREET HEALTHCARE ASSOCIATES LLC
Doing business as
DESERT TERRACE HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1972
Last certification
Oct 20, 2023
Beds
108
Ownership / control type
Corporation
Multi-facility organization
Bandera Healthcare
Organization structure
LLCProprietary
Incorporated
Feb 11, 2002 in NV
Enrollment address
2509 N 24TH St
Phoenix, AZ 85008-1805
Nursing home name
DESERT TERRACE HEALTHCARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Desert Terrace Healthcare CenterCCN 035014 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 1, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10886.9 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0692263Desert Terrace Healthcare Center2509 N 24TH St, Phoenix, AZ 85008Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Terrace Holdings Az LLC Organization, San Clemente, CA LLC, Holding company Adp of the SNF Apr 1, 2002
Alex Eaton Individual Operational/Managerial Control Dec 19, 2025
Managing Control - Governing BodyAdministrator Dec 19, 2025
Adp of the SNF Dec 19, 2025
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2002 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation, For-profit Adp of the SNF Aug 1, 2002
Forrest Peterson Individual Corporate DirectorDirector Jan 1, 2019
Bandera Healthcare LLC Organization, San Juan Capistrano, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 30, 2006 100%
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Jan 1, 2022
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF Apr 1, 2002
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Apr 1, 2002
Chad Keetch Individual Corporate OfficerSecretary Mar 1, 2011
Omair Hasan Individual Operational/Managerial Control Mar 30, 2020
Managing Control - Governing BodyMedical Director Mar 30, 2020
Adp of the SNF Mar 30, 2020
Soon Burnam Individual Corporate OfficerSecretary Sep 25, 2006
Managing Control - Governing BodyAuthorized Official Sep 25, 2006

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Omair Hasan, M.D.
    • Internal Medicine Physician
    • Phoenix, AZ
    • NPI 1740420041

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 31

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 31

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1760477541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850081805",
            "telephone_number": "602-273-1347",
            "fax_number": "602-273-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850081805",
            "telephone_number": "602-273-1347",
            "fax_number": "602-273-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "24TH STREET HEALTHCARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "949-540-1249",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688062",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Desert Terrace Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desert Terrace Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.