3Rd and Indian School Assisted Living Facility, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

3RD AND INDIAN SCHOOL ASSISTED LIVING FACILITY, LLC

Practice address

4000 N 3Rd Ave
Phoenix, AZ 85013-1285

Phone

(217) 620-9874

NPI assigned

Jan 6, 2025

Last updated

Jan 6, 2025By 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

Jo Ellen Bleavins

Title

President and Ceo

Phone

(217) 620-9874

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1912716705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W WACKER DR STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606011781",
            "telephone_number": "217-620-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 N 3RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131285",
            "telephone_number": "217-620-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3RD AND INDIAN SCHOOL ASSISTED LIVING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "BLEAVINS",
        "authorized_official_first_name": "JO ELLEN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "217-620-9874"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 Jan 6, 2025; 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.