Gladys Tih Owuor

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12476 Issued in AZ

Practice address

13045 W Port Royale LN
El Mirage, AZ 85335-3428

Phone

(602) 592-5954

NPI assigned

Jun 24, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sunrise Gardens Assisted Living LLC

  • Assisted Living Facility (Behavioral Disturbances)
  • El Mirage, AZ
  • NPI 1063250025
  NPD

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1780428763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13524 W READE AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853404019",
            "telephone_number": "602-592-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13045 W PORT ROYALE LN",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "853353428",
            "telephone_number": "602-592-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIH OWUOR",
        "first_name": "GLADYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL12476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ID",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in El Mirage, AZ
• Providers in El Mirage, 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 Jun 24, 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.