Des Moines Specialized Care

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

136599 Issued in AZ

Legal business name

DES MOINES SPECIALIZED CARE

Doing business as

Specialized Assisted Living, LLC

Practice address

15029 N Thompson Peak Pkwy
Suite B-111, #418
Scottsdale, AZ 85260-2217

Phone

(602) 793-6265

Fax

(480) 621-5842

NPI assigned

Apr 5, 2012

Organization subpart

Yes

Parent organization

SPECIALIZED ASSISTED LIVING, LLCAs reported in NPPES

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

Authorized official

Name

Lucian Saucan

Title

Owner

Phone

(602) 793-6265

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Specialized Assisted Living, LLC Doing business as

Part of

Des Moines Specialized Care

Locations

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1770849648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15029 N. THOMPSON PEAK PKWAY",
            "address_2": "SUITE B-111, #418",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85260",
            "telephone_number": "602-793-6265",
            "fax_number": "480-621-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15029 N THOMPSON PEAK PKWY",
            "address_2": "SUITE B-111, #418",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602217",
            "telephone_number": "602-793-6265",
            "fax_number": "480-621-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DES MOINES SPECIALIZED CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALIZED ASSISTED LIVING, LLC",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "SAUCAN",
        "authorized_official_first_name": "LUCIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-793-6265"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "136599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136599",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialized Assisted Living, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Augustine Derose, D.P.M.
• Nicole M Derosier, FNP-BC
• Gail Bass Derscheid, O.D.
• Gary L Derscheid, PT, ATC
• Jennifer L Derse, DDS
• Janki Desai, MD
• Rahul A Desai, MD
• Rini Manoj Desai, MD
• Desert Ancillary Services PLLC
• Desert Anesthesia Consultants LTD

• Assisted Living Facility in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; 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.