Active NPI
Lilac Assisted Living LLC
- Assisted Living Facility
- Phoenix, AZ
National Provider Identifier
1982517330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- LILAC ASSISTED LIVING LLC
- Practice address
- 2123 W Branham LN
Phoenix, AZ 85041-7723 - Phone
- (818) 984-4906
- NPI assigned
- Sep 25, 2026
- Last updated
- Sep 29, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mariah Velsa
- Title
- Owner
- Phone
- (818) 984-4906
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | NU | Primary |
Addresses
Primary practice location
2123 W Branham LN
Phoenix, AZ 85041-7723
Mailing address
13309 W Monterey Way
Litchfield Park, AZ 85340-5914
Phone (818) 984-4906
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 223693 | Medicaid | AZ |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790640000000",
"number": "1982517330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13309 W MONTEREY WAY",
"city": "LITCHFIELD PARK",
"state": "AZ",
"postal_code": "853405914",
"telephone_number": "818-984-4906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2123 W BRANHAM LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850417723",
"telephone_number": "818-984-4906"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LILAC ASSISTED LIVING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-25",
"last_updated": "2026-09-29",
"certification_date": "2026-09-29",
"status": "A",
"authorized_official_last_name": "VELSA",
"authorized_official_first_name": "MARIAH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "818-984-4906"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "223693",
"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 Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.