Illuminated Hearts LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ILLUMINATED HEARTS LLC

Practice address

7475 E Rio Vista Cir
Tucson, AZ 85715-3547

Phone

(520) 304-1502

NPI assigned

Oct 5, 2022

Last updated

Oct 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reynaldo Mendibles Jr.NPI 1760106611

Title

Member/Owner

Phone

(520) 304-1502

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reynaldo Mendibles Jr.

  • Assisted Living Facility
  • Tucson, AZ
  • NPI 1760106611
  NPD Authorized official

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1902521602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7475 E RIO VISTA CIR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153547",
            "telephone_number": "520-304-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7475 E RIO VISTA CIR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153547",
            "telephone_number": "520-304-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATED HEARTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "MENDIBLES",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "520-304-1502",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA HEALTH DEPARTMENT",
            "identifier": "AL12291H",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Tucson, AZ
• Providers in Tucson, 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 5, 2022; 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.