The Pines at Prescott Valley LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE PINES AT PRESCOTT VALLEY LLC

Doing business as

Ativo Senior Living Prescott Valley

Practice address

3951 N Viewpoint Dr
Prescott Valley, AZ 86314-2689

Phone

(928) 888-6246

NPI assigned

Oct 13, 2023

Last updated

Oct 13, 2023By 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

Mr. Ronald Ziebart, N/A

Title

Managing Member

Phone

(503) 363-4636

Specialties & licenses 1

Addresses

Other names 1

• Ativo Senior Living Prescott Valley Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1922889047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HINES ST SE STE 190",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021356",
            "telephone_number": "201-401-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3951 N VIEWPOINT DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142689",
            "telephone_number": "928-888-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PINES AT PRESCOTT VALLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "ZIEBART",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-363-4636",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ativo Senior Living Prescott Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Telck, PHARMD
• Kimberleigh Telling, FNP-C
• Neil Harvey Tewes, RPH
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Prescott Valley)
• The Highway: a Self-Harm and Suicide Prevention Service
• The Servant Group LLC
• Amy M Thein, FNP
• Sarah Thomas, M.A., LAC
• Thompson & Barrett Dental PLLC (Highland Dental)
• Katherine Lee Thompson, P.T.

• Assisted Living Facility in Prescott Valley, AZ
• Providers in Prescott Valley, 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 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.