St Charles Place

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL 8954H Issued in AZ

Legal business name

ST CHARLES PLACE

Doing business as

st charles place III

Practice address

6818 S 16TH PL
Phoenix, AZ 85042-5714

Phone

(602) 276-0084

Fax

(602) 595-9969

NPI assigned

Jul 13, 2015

Organization subpart

Yes

Parent organization

ST CHARLES PLACEAs reported in NPPES

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

Authorized official

Name

James Williams, MSW

Title

Manager/Owner

Phone

(602) 276-0084

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• st charles place III Doing business as

Part of

Greenleaf Adult Family Care Home

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1861876500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6818 S 16TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425714",
            "telephone_number": "602-276-0084",
            "fax_number": "602-595-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6818 S 16TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425714",
            "telephone_number": "602-276-0084",
            "fax_number": "602-595-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CHARLES PLACE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST CHARLES PLACE",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "602-276-0084",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL3064H",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL 8954H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426933",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "st charles place III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Phoenix, AZ
• Providers in Phoenix, 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 Jul 13, 2015; 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.