NPIMap

Organization Active NPI

Archie Hendricks Sr Skilled Nursing Facility

  • Rehabilitation Clinic/Center
  • Sells, AZ
National Provider Identifier
1962810127
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
TRIBAL SERVICE Issued in AZ
Legal business name
ARCHIE HENDRICKS SR SKILLED NURSING FACILITY
Practice address
Federal Route 15 Milepost 9
Sells, AZ 85634-9744
Phone
(520) 585-5500
Fax
(520) 585-5500
NPI assigned
Jul 31, 2014
Organization subpart
Yes
Parent organization
ARCHIE HENDRICKS SR SKILLED NURSING FACILITYAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
James A Chaston
Title
Cfo/Business Office Director
Phone
(520) 585-5500

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Archie Hendricks Sr Skilled (3 organizations share this tax ID)
Part of
Archie Hendricks Sr Skilled

Locations

9100 HC 1
Sells, AZ 85634
Phone (520) 361-1800

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X TRIBAL SERVICE AZ Primary

Addresses

NPPES NPI Registry

Primary practice location

Federal Route 15 Milepost 9
Sells, AZ 85634-9744

Mailing address

HC 1 Box 9100
Sells, AZ 85634-9744
Phone (520) 585-5500

Other names 1

NPPES NPI Registry
  • Archie Hendricks Outpatient Rehab Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 28, 2024.

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1962810127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 9100",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "856349744",
            "telephone_number": "520-585-5500",
            "fax_number": "520-585-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FEDERAL ROUTE 15 MILEPOST 9",
            "city": "SELLS",
            "state": "AZ",
            "postal_code": "856349744",
            "telephone_number": "520-585-5500",
            "fax_number": "520-585-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHIE HENDRICKS SR SKILLED NURSING FACILITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARCHIE HENDRICKS SR SKILLED NURSING FACILITY",
        "enumeration_date": "2014-07-31",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "CHASTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO/BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "520-585-5500"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "AZ",
            "license": "TRIBAL SERVICE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Archie Hendricks Outpatient Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Archie Hendricks Outpatient Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sells, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.