Living Water for Life Medical Ministry

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

LIVING WATER FOR LIFE MEDICAL MINISTRY

Practice address

11435 W Buckeye Rd Ste 104-271
Avondale, AZ 85323-6812

Phone

(602) 598-0903

NPI assigned

Mar 8, 2021

Organization subpart

No

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

Authorized official

Name

Karen Farmer

Title

NP

Phone

(602) 598-0903

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1780279117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11435 W BUCKEYE RD STE 104-271",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853236812",
            "telephone_number": "602-598-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11435 W BUCKEYE RD STE 104-271",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853236812",
            "telephone_number": "602-598-0903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25550 W Desert Dr",
            "address_purpose": "LOCATION",
            "city": "Buckeye",
            "state": "AZ",
            "postal_code": "853265148",
            "country_code": "US",
            "telephone_number": "623-399-0452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVING WATER FOR LIFE MEDICAL MINISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "602-598-0903"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "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 May 18, 2021; 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.