Avaya Therapy of Arizona LLC

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

Legal business name

AVAYA THERAPY OF ARIZONA LLC

Practice address

18185 N 83Rd Ave Ste 206
Glendale, AZ 85308-0519

Phone

(708) 408-2258

NPI assigned

Feb 2, 2024

Last updated

Feb 2, 2024By 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

Rolando Arrojo

Title

Member

Phone

(312) 404-9639

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1902669807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18185 N 83RD AVE STE 206",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18185 N 83RD AVE STE 206",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853080519",
            "telephone_number": "708-408-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVAYA THERAPY OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "ARROJO",
        "authorized_official_first_name": "ROLANDO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "312-404-9639"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Avid Support Resources LLC

• Wound Care Registered Nurse in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Wound Care Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.