ILHC OF PHOENIX, LLC (NPI# 1902983265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902983265 |
| Entity Type | Organization |
| Organization Name | ILHC OF PHOENIX, LLC |
| Other Organization Name | ARIZONA GRAND SENIOR LIVING COMMUNITY |
| Practice Address |
4602 N 24th St Phoenix AZ 85016-5253 |
| Mailing Address |
1107 Hazeltine Blvd Suite 200 Chaska MN 55318-1009 |
| Practice Telephone | 6029549178 |
| Practice Fax Number | 6025538344 |
| Mailing Telephone | 9523618000 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-12-08 |
| Authorized Official Name | ELAINE R. BURTON (PRESIDENT & CHAIR OF BD OF MANAGERS) |
| Authorized Official Telephone | 9523618000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | ALC-5695 | AZ | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | NCI-2656 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS OF ARIZONA | AZ0914230 | 01 |
| Other Name | Type Code |
|---|---|
| ARIZONA GRAND SENIOR LIVING COMMUNITY | Doing Business As Name - Organization |
| Street Address |
4602 N 24TH ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-5253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205824653 | Arizona Eastern Star Retirement Center | Skilled Nursing Facility | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2005-10-10 |
| 1689099228 | Lynley Stillman | Physical Therapy Assistant | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2014-02-19 |
| 1740622687 | Lisa Suhr | Occupational Therapy Assistant | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2013-07-19 |
| 1134567704 | Shirley Cheng | Occupational Therapist | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2013-06-05 |
| 1073957460 | Jamie Lee Noble | Occupational Therapy Assistant | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2013-04-29 |
| 1477895316 | Barbara S Sainz | Physical Therapist | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2013-03-18 |
| 1346581188 | Vanessa Cheryl Irving | Physical Therapy Assistant | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2013-03-04 |
| 1356682199 | Ann Browning | Physical Therapist | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2013-03-04 |
| 1427398445 | Kathleen A Bridges | Occupational Therapy Assistant | 4602 N 24th St, Phoenix, AZ 85016-5253 | 2013-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| 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.