DESERT GEM ASSISTED LIVING FACILITY, LLC (NPI# 1770125403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770125403 |
| Entity Type | Organization |
| Organization Name | DESERT GEM ASSISTED LIVING FACILITY, LLC |
| Practice Address |
3236 W. Eugie Avenue Phoenix AZ 85029 |
| Mailing Address |
1734 E. Bahrend Drive Phoenix AZ 85024-1205 |
| Practice Telephone | 4806393290 |
| Practice Fax Number | 4806395748 |
| Mailing Telephone | 4802085137 |
| Mailing Fax Number | 4803695748 |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2019-10-15 |
| Authorized Official Name | MR. DIOSCORO ANGELO TAGLE JR. (OWNER/MANAGER) |
| Authorized Official Telephone | 4802085137 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
3236 W. EUGIE AVENUE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153799 | Haydee Bermudez | Counselor | 3301 North 33rd Ave., Phoenix, AZ 85029 | 2020-10-27 |
| 1871191221 | Covenant Home Health LLC | In Home Supportive Care | 11830 N. 19th Ave, Suite 101 Pendleton, Phoenix, AZ 85029 | 2020-10-16 |
| 1508406745 | Tailored 2 U Psychiatry, Pllc | Nurse Practitioner | 4150 W Peoria Avenue, Suite 116, Phoenix, AZ 85029 | 2020-01-15 |
| 1588128623 | Anna Debbs | Counselor | 11221 North 28th Drive, Bldg E, Phoenix, AZ 85029 | 2019-01-23 |
| 1609360007 | Melissa Lynn Denton | Specialist/Technologist | 4014 W Paradise Dr, Phoenix, AZ 85029 | 2018-06-19 |
| 1275038713 | Jamilah Amirah | Behavioral Analyst | 11024 N 28th Dr Ste 110, Phoenix, AZ 85029 | 2018-03-27 |
| 1639687056 | Empower Home Care, LLC. | Home Health | 11225 N 28th Drive, Suite D115e, Phoenix, AZ 85029 | 2018-01-19 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1073966347 | Meka Joi Green | Social Worker | 11225 M 28th Dr, Suite C210, Phoenix, AZ 85029 | 2016-07-21 |
| 1851777643 | Total Wellness Acupuncture LLC | Acupuncturist | 3201 W. Peoria Ave, Suite # C-607, Phoenix, AZ 85029 | 2015-08-04 |
| Find all providers in zip 85029 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932725835 | Oasis Group Home LLC | Custodial Care Facility | 2206 W. Spur Dr., Phoenix, AZ 85085-5752 | 2020-06-17 |
| 1124679931 | Lovin Touch LLC | Custodial Care Facility | 4130 W Northern Ave, Phoenix, AZ 85051-5765 | 2019-09-23 |
| 1164070819 | Love Shines Behavioral Health Homes LLC | Custodial Care Facility | 16401 N 39th Pl, Phoenix, AZ 85032-3246 | 2019-08-27 |
| 1386147262 | Desert View Assisted Living | Custodial Care Facility | 9401 N 36 Ave, Phoenix, AZ 85051-3305 | 2018-03-16 |
| 1699289215 | Desert Springs Care Home L.L.C. | Custodial Care Facility | 3445 W Acoma Dr, Phoenix, AZ 85053-5620 | 2017-11-17 |
| 1750817763 | Flerida Cabatic | Custodial Care Facility | 27413 N 23rd Dr, Phoenix, AZ 85085-4708 | 2017-05-11 |
| 1679947238 | Garcia's Assisted Living Home LLC | Custodial Care Facility | 2742 E Pueblo Avenue, Phoenix, AZ 85040 | 2015-11-19 |
| 1447645833 | Az Advanced Care LLC | Custodial Care Facility | 3137 W Lane Ave, Phoenix, AZ 85051-6522 | 2015-04-02 |
| 1447643069 | Caring Haven Homes LLC | Custodial Care Facility | 420 W Sequoia Dr, Phoenix, AZ 85027-4727 | 2015-03-05 |
| 1346645702 | Rebecca Siddiqui | Custodial Care Facility | 4113 W Hayward Ave, Phoenix, AZ 85051-5751 | 2014-10-28 |
| 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.