Ilhc of Phoenix, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-2656 Issued in AZ

Legal business name

ILHC OF PHOENIX, LLC

Doing business as

Arizona Grand Senior Living Community

Practice address

4602 N 24TH St
Phoenix, AZ 85016-5253

Phone

(602) 954-9178

Fax

(602) 553-8344

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Elaine R. Burton

Title

President & Chair of BD of Managers

Phone

(952) 361-8000

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• ARIZONA GRAND SENIOR LIVING COMMUNITY Doing business as

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1902983265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 HAZELTINE BLVD",
            "address_2": "SUITE 200",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181009",
            "telephone_number": "952-361-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165253",
            "telephone_number": "602-954-9178",
            "fax_number": "602-553-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILHC OF PHOENIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT & CHAIR OF BD OF MANAGERS",
        "authorized_official_telephone_number": "952-361-8000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC-5695",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-2656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ARIZONA",
            "identifier": "AZ0914230",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARIZONA GRAND SENIOR LIVING COMMUNITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Ifunanya Ike, MD
• Elizabeth N Ike, PHARMACIST
• Uche Ike, PMHNP
• Sage Ilas, FNP
• Debra Ilchak
• Danijela Ilie, LMT
• Anthony E Iliff, PA-C
• Illuminate Behavioral Consulting, LLC
• Illuminated Counseling, PLLC
• Robert Helmut Illy

• Skilled Nursing Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.