SNH Az Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SNH AZ TENANT LLC

Doing business as

The Forum at Desert Harbor

Practice address

13840 N Desert Harbor Dr
Peoria, AZ 85381-3501

Phone

(623) 972-0995

Fax

(623) 977-5271

NPI assigned

Aug 21, 2019

Organization subpart

Yes

Parent organization

SNH AZ TENANT LLCAs reported in NPPES

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

Authorized official

Name

Jennifer F. Mintzer

Title

President & Chief Operating Officer

Phone

(617) 796-8350

Specialties & licenses 2

Addresses

Other names 1

• The Forum at Desert Harbor Doing business as

Part of

SNH Az Tenant LLC

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1821645268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13840 N DESERT HARBOR DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813501",
            "telephone_number": "623-972-0995",
            "fax_number": "623-977-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH AZ TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH AZ TENANT LLC",
        "enumeration_date": "2019-08-21",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Forum at Desert Harbor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Forum at Desert Harbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Peoria, AZ
• Providers in Peoria, 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 Oct 11, 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.