NPIMap

Organization Active NPI

Golden Memories

  • Adult Care Home Facility
  • Phoenix, AZ
National Provider Identifier
1972899656
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
506154 Issued in AZ
Legal business name
GOLDEN MEMORIES
Practice address
219 W Villa Theresa Dr
Phoenix, AZ 85023-6431
Phone
(602) 547-6992
Fax
(602) 978-9376
NPI assigned
Jun 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Authorized official

Name
Maria Cristea
Title
Manager
Phone
(602) 547-6992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 506154 AZ Primary

Addresses

Primary practice location

219 W Villa Theresa Dr
Phoenix, AZ 85023-6431

Mailing address

219 W Villa Theresa Dr
Phoenix, AZ 85023-6431
Phone (602) 547-6992

Other identifiers 1

IdentifierTypeStateIssuer
506154MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1972899656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 W VILLA THERESA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850236431",
            "telephone_number": "602-547-6992",
            "fax_number": "602-978-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W VILLA THERESA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850236431",
            "telephone_number": "602-547-6992",
            "fax_number": "602-978-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN MEMORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "CRISTEA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-547-6992"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "506154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506154",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.