Twilight Haven III

Primary specialty

Adult CompanionTaxonomy code 372600000X

License

AL85714 Issued in AZ

Legal business name

TWILIGHT HAVEN III

Practice address

233 S. 123Rd Dr.
Avondale, AZ 85323-8043

Phone

(623) 234-4034

Fax

(623) 234-4525

NPI assigned

Apr 23, 2012

Last updated

Apr 23, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

TWILIGHT HAVEN - ASSISTED LIVING HOMEAs reported in NPPES

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

Authorized official

Name

Mrs. Justyna J Chatkowski

Title

Caregiver

Phone

(602) 819-4951

Specialties & licenses 1

Addresses

Part of

Twilight Haven III

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1821355215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S. 123RD DR.",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853238043",
            "telephone_number": "623-234-4034",
            "fax_number": "623-234-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 S. 123RD DR.",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853238043",
            "telephone_number": "623-234-4034",
            "fax_number": "623-234-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWILIGHT HAVEN III",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TWILIGHT HAVEN - ASSISTED LIVING HOME",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "CHATKOWSKI",
        "authorized_official_first_name": "JUSTYNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CAREGIVER",
        "authorized_official_telephone_number": "602-819-4951",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "AZ",
            "license": "AL85714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlrolette Tuitavuki
• Nadia Tumusabire, RBT
• Larry Nathaniel Wright Turkson
• Brittany Turpen, LPC
• Tallona Twiggs
• Nicholas Stanley Tymochko, PHARMD
• Ultimate Health Clinic, LLC
• Success Umesiri
• Jessica Umpstead
• University of Medical Sciences Arizona (The Lionel Holder Rehabilitation Clinic)

• Adult Companion in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Adult Companion in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.