PASTALINO MANOR LLC 3 (NPI# 1598124075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598124075 |
| Entity Type | Organization |
| Organization Name | PASTALINO MANOR LLC 3 |
| Practice Address |
2264 W Olive Way Chandler AZ 85248-4184 |
| Mailing Address |
1383 W Kesler Ln Chandler AZ 85224-7289 |
| Practice Telephone | 4804047139 |
| Mailing Telephone | 4806345485 |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-02-12 |
| Authorized Official Name | MR. PAUL KIVILA (OWNER/CEO) |
| Authorized Official Telephone | 4806345485 |
| Authorized Official Credential | B.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH4822 | AZ | Residential Treatment Facilities |
| Street Address |
2264 W OLIVE WAY |
| City | CHANDLER |
| State | AZ |
| Zip Code | 85248-4184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063019669 | Sona Dds PC | Dentist | 10450 E. Riggs Rd. #118, Chandler, AZ 85248 | 2020-10-06 |
| 1629618962 | Danica Lynne Williams | Counselor | 3800 S. Nebraska St., Chandler, AZ 85248 | 2020-01-15 |
| 1346743473 | Kiana Tess Tahiri | Behavioral Analyst | 3952 South Waterfront Drive, Chandler, AZ 85248 | 2018-03-15 |
| 1922508076 | Kaitlyn Christine Jones | Specialist/Technologist | 3700 S Arizona Ave, Chandler, AZ 85248 | 2018-02-15 |
| 1053833038 | Moc Chandler, LLC | Skilled Nursing Facility | 3033 South Arizona Ave., Chandler, AZ 85248 | 2017-07-12 |
| 1881064145 | Sonya Kay Kooima | Nurse Practitioner | 965 W. Chandler Heights Rd., Chandler, AZ 85248 | 2015-09-30 |
| 1215313028 | Taylor Froiland | Pharmacist | 4995 S Alma School Rd Ste 4, Chandler, AZ 85248 | 2015-08-04 |
| 1518380468 | Julie Ybarra | Speech-Language Pathologist | 1500 E.chandler Heights Rd., Chandler, AZ 85248 | 2014-01-29 |
| 1710218326 | Vijay Jain | Dentist | 1445 South Arizona Ave, Suite 1, Chandler, AZ 85248 | 2010-01-21 |
| 1700113156 | Lavon Williams | Registered Nurse | 10440 E. Riggs Road, Suite 207, Chandler, AZ 85248 | 2009-11-05 |
| Find all providers in zip 85248 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387490 | Serenity Residential Homes, LLC | Community Based Residential Treatment Facility, Mental Illness | 101 W Hackberry Dr, Chandler, AZ 85248-4012 | 2020-05-13 |
| 1679118848 | Jf Residential LLC | Community Based Residential Treatment Facility, Mental Illness | 2225 W Frye Rd, Chandler, AZ 85224-6477 | 2019-11-12 |
| 1073175048 | A Brighter Day Living Center LLC | Community Based Residential Treatment Facility, Mental Illness | 264 N Exeter St, Chandler, AZ 85225-4657 | 2019-06-30 |
| 1003314428 | Victory Manor LLC. | Community Based Residential Treatment Facility, Mental Illness | 1041 S Yucca Pl, Chandler, AZ 85286-0982 | 2018-01-31 |
| 1770931966 | Jussamal Manor 11 | Community Based Residential Treatment Facility, Mental Illness | 641 S. Karen Dr., Chandler, AZ 85224 | 2016-05-27 |
| 1881001832 | Better Horizons LLC | Community Based Residential Treatment Facility, Mental Illness | 2204 E Firestone Dr, Chandler, AZ 85249-4636 | 2014-07-22 |
| 1487923439 | Winding Woods Manor L,l.c. | Community Based Residential Treatment Facility, Mental Illness | 3691 S Ashley Pl, Chandler, AZ 85286-2618 | 2011-12-20 |
| 1568740801 | Jussamal Manor | Community Based Residential Treatment Facility, Mental Illness | 3047 E Kingbird Pl, Chandler, AZ 85286-5615 | 2011-08-03 |
| 1396057600 | Odel Burnes Sr. | Community Based Residential Treatment Facility, Mental Illness | 3268 E Goldfinch Way, Chandler, AZ 85286-5732 | 2010-07-02 |
| 1174703995 | Osceola Bowlin Inc | Community Based Residential Treatment Facility, Mental Illness | 2144 E Indian Wells Dr, Chandler, AZ 85249-4865 | 2007-11-08 |
| Find all providers in CHANDLER | ||||
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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.