Ventana Winds LLC
Organization Active NPI Assisted Living Facility · Youngtown, AZ
NPI 1942736582 · NPPES record last updated May 2, 2017
Key facts
- NPI
- 1942736582
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- AL8153C (AZ)
- Legal business name
- VENTANA WINDS LLC
- Practice address
- 12322 N 113TH Ave
Youngtown, AZ 85363-1268 - Phone
- (623) 583-2460
- Fax
- (623) 583-4677
- NPI assigned
- May 2, 2017
- Organization subpart
- No
Authorized official
- Name
- Melba White, LPN
- Title
- Regional Director
- Phone
- (623) 583-2460
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D1099096 | Ventana Winds Assisted Living & Memory Care | Certificate of waiver | May 4, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL8153C | AZ | Yes |
Addresses
Primary practice location
12322 N 113TH Ave
Youngtown, AZ 85363-1268
Mailing address
12322 N 113TH Ave
Youngtown, AZ 85363-1268
Phone (623) 583-2460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 541617 | Medicaid | AZ |
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All providers in Youngtown, AZ · Assisted Living Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.