Desert Gem Assisted Living Facility, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

DESERT GEM ASSISTED LIVING FACILITY, LLC

Practice address

3236 W. Eugie Avenue
Phoenix, AZ 85029

Phone

(480) 639-3290

Fax

(480) 639-5748

NPI assigned

Oct 15, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Dioscoro Angelo Tagle Jr.

Title

Owner/Manager

Phone

(480) 208-5137

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1770125403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 E. BAHREND DRIVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241205",
            "telephone_number": "480-208-5137",
            "fax_number": "480-369-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 W. EUGIE AVENUE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85029",
            "telephone_number": "480-639-3290",
            "fax_number": "480-639-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT GEM ASSISTED LIVING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "TAGLE",
        "authorized_official_first_name": "DIOSCORO",
        "authorized_official_middle_name": "ANGELO",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "480-208-5137",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "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 Phoenix, AZ
• Providers in Phoenix, 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 Oct 15, 2019; 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.