PHOENIX HEALTHCARE LLC (NPI# 1275712002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275712002 |
| Entity Type | Organization |
| Organization Name | PHOENIX HEALTHCARE LLC |
| Other Organization Name | GRACE HEALTHCARE OF PHOENIX |
| Practice Address |
4202 N 20th Ave Phoenix AZ 85015-5101 |
| Practice Telephone | 6022643824 |
| Practice Fax Number | 6022796234 |
| Mailing Telephone | 6022643824 |
| Mailing Fax Number | 6022796234 |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2008-04-17 |
| Authorized Official Name | MRS. ALICE MARIE CLARK DANKS (VP OF FINANCE) |
| Authorized Official Telephone | 4233081845 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NCI-2667 | AZ | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Grace Healthcare of Phoenix | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356454094 | Phoenix Healthcare LLC | Nursing Facility/Intermediate Care Facility | 1503 Har-ber Rd, Grove, OK 74344-3525 | 2006-08-16 |
| 1780694711 | Phoenix Healthcare LLC | Nursing Facility/Intermediate Care Facility | 1165 S. Brenner Rd, Sapulpa, OK 74066-6141 | 2006-08-09 |
| 1740296490 | Phoenix Healthcare LLC | Skilled Nursing Facility | 3601 N Columbia Ave, Tulsa, OK 74110-1232 | 2006-08-01 |
| 1891700761 | Phoenix Healthcare LLC | Skilled Nursing Facility | 5701 W Britton Rd, Oklahoma City, OK 73132-2402 | 2006-07-29 |
| 1104830421 | Phoenix Healthcare LLC | Skilled Nursing Facility | 1944 N Iroquois Ave, Tulsa, OK 74106-4407 | 2006-07-29 |
| 1366493066 | Phoenix Healthcare LLC | Skilled Nursing Facility | 1235 Yancey St, Roanoke, AL 36274-2141 | 2006-05-15 |
| 1780687590 | Phoenix Healthcare LLC | Skilled Nursing Facility | 10912 E 14th St, Tulsa, OK 74128-4845 | 2005-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Phoenix Healthcare LLC | 52 Riley Road, #318, Celebration, FL 34747 |
| North Carolina Corporations | Phoenix Healthcare LLC | 176 Mine Lake Court Suite 100, Raleigh, NC 27615-6417 |
| Street Address |
4202 N 20TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285741587 | Dina I Zaza IIi | Physical Medicine & Rehabilitation | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2006-08-23 |
| 1629676135 | Nicole Alison Fukuzawa | Occupational Therapist | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2020-10-16 |
| 1063975720 | Louis Bartlo IIi | Physical Therapist | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2019-04-10 |
| 1104389980 | Shannon Halstead | Physical Therapist | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2019-04-09 |
| 1437612223 | Rachel Knowles | Occupational Therapist | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2019-04-09 |
| 1215383237 | Haven of Phoenix LLC | Skilled Nursing Facility | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2016-05-09 |
| 1518308592 | Zaza Rehabmd LLC | Physical Medicine & Rehabilitation | 4202 N 20th Ave, Phoenix, AZ 85015-5101 | 2013-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326592825 | Lifestream Complete Senior Living At Northeast Phoenix, Inc. | Skilled Nursing Facility | 20802 N. Cave Creek Road, Building 86, Phoenix, AZ 85024 | 2016-08-12 |
| 1548657083 | Kindred Nursing Centers West, LLC | Skilled Nursing Facility | 1880 E Van Buren St, Phoenix, AZ 85006-3742 | 2015-04-22 |
| 1396972667 | Caremeridian, LLC | Skilled Nursing Facility | 5301 E Thomas Rd, Phoenix, AZ 85018-8011 | 2009-06-15 |
| 1649440751 | Pinnacle Health Facilities Xxv Lp | Skilled Nursing Facility | 15810 South 42nd Street, Phoenix, AZ 85048-7409 | 2008-03-04 |
| 1619058120 | Humangood Arizona Inc. | Skilled Nursing Facility | 7550 N 16th St, Phoenix, AZ 85020 | 2006-10-18 |
| 1326134107 | Senior Living Options Maryland Gardens, LLC | Skilled Nursing Facility | 31 W Maryland Ave, Phoenix, AZ 85013-1227 | 2006-10-05 |
| 1013009745 | State of Arizona State Dept of Finance | Skilled Nursing Facility | 4141 North S. Herrera Way, Phoenix, AZ 85012 | 2006-09-29 |
| 1811096738 | Srcv Haven, LLC | Skilled Nursing Facility | 2645 East Thomas Road, Phoenix, AZ 85016-8201 | 2006-09-21 |
| 1275570269 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 8008 S Jesse Owens Pkwy, Phoenix, AZ 85042-6516 | 2006-05-31 |
| 1659324242 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 4065 E Bell Rd, Phoenix, AZ 85032-2208 | 2006-05-18 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.