LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE INC (NPI# 1932105962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932105962 |
| Entity Type | Organization |
| Organization Name | LIFESTREAM COMPLETE SENIOR LIVING AT SUN RIDGE INC |
| Other Organization Name | LIFESTREAM AT SUN RIDGE |
| Practice Address |
12215 W Bell Rd Surprise AZ 85378-9640 |
| Practice Telephone | 6235835482 |
| Practice Fax Number | 6235831465 |
| Mailing Telephone | 6235835482 |
| Mailing Fax Number | 6235831465 |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2013-05-21 |
| Authorized Official Name | MR. RONALD ESTES (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6239333333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NCI-406 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 390922 | 05 | |
| AZ | MERCY CARE ADVANTAGE | 1025242 | 01 |
| AZ | BLUE CROSS BLUE SHIELD | AZ0402330 | 01 |
| Other Name | Type Code |
|---|---|
| LifeStream at Sun Ridge | Doing Business As Name - Organization |
| Street Address |
12215 W BELL RD |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85378-9640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467947101 | Destiny Springs Healthcare, LLC | Psychiatric Hospital | 17300 N. Dysart Road, Surprise, AZ 85378 | 2018-06-26 |
| 1881013480 | Amanda Brimlow | Specialist | 12425 West Bell Rd, Suite 200, Surprise, AZ 85378 | 2014-04-10 |
| 1598193104 | Kalin Marie Harding | Nurse Practitioner | 12425 W. Bell Rd., Suite 106, Suprise, AZ 85378 | 2013-10-16 |
| 1043651540 | Rachel Sara Herrin | Internal Medicine | 12665 W. Smokey Dr., #140, Surprise, AZ 85378 | 2013-07-12 |
| 1962756528 | Daniel Allen Dryer | Registered Nurse | 11607 W. Mingus Mt. Ct., Surprise, AZ 85378 | 2012-11-05 |
| 1124374715 | Rabeca Vatamaniuc | Home Health Aide | 11151 W Lily Mckinley Dr, Surprise, AZ 85378 | 2012-08-01 |
| 1710073457 | Arizona's Children Association | Clinic/Center | 11321 West Bell Road, Suite 401, Surprise, AZ 85378 | 2006-10-04 |
| 1538429121 | Sr Billing | Anesthesiology | 12361 W Bola Dr, Suite 109, Surprise, AZ 85378 | 2012-05-17 |
| 1457515579 | Madhuri Dhupati & Associates Md PC. | Clinic/Center | 12647 W Smokey Dr Ste 119, Surprise, AZ 85378 | 2008-07-17 |
| 1205267119 | Post-acute Physicians of Arizona Pllc | Physical Medicine & Rehabilitation | 13060 W Bell Rd, Surprise, AZ 85378-1200 | 2013-12-02 |
| Find all providers in zip 85378 | ||||
| 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 |
|---|---|---|---|---|
| 1487215067 | Ludden Healthcare, Inc. | Skilled Nursing Facility | 14660 W Parkwood Dr, Surprise, AZ 85374-4590 | 2019-06-25 |
| 1396208955 | Manuella D Khoshaba | Skilled Nursing Facility | 13821 W Crocus Dr, Surprise, AZ 85379-8340 | 2019-04-10 |
| 1518489244 | Moc Surprise, LLC | Skilled Nursing Facility | 14660 West Parkwood Drive, Surprise, AZ 85374 | 2017-07-14 |
| 1992096101 | Asante Trc of Surprise LLC | Skilled Nursing Facility | 14775 W. Yorkshire Dr., Surprise, AZ 85374-7213 | 2011-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630175 | P. Deanda Medical Pllc | Skilled Nursing Facility | 1950 W Paseo Monserrat, Tucson, AZ 85704-1329 | 2020-05-12 |
| 1477187995 | Welbrook Yuma Opco LLC | Skilled Nursing Facility | 2271 S Ridgeview Dr, Yuma, AZ 85364-8872 | 2020-02-24 |
| 1780106765 | Moc Tucson, LLC | Skilled Nursing Facility | 5151 East Pima Street, Tucson, AZ 85712 | 2017-07-12 |
| 1053833038 | Moc Chandler, LLC | Skilled Nursing Facility | 3033 South Arizona Ave., Chandler, AZ 85248 | 2017-07-12 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1609307354 | Tucson Hacienda River, LLC | Skilled Nursing Facility | 2720 E River Road, Tucson, AZ 85718 | 2017-03-24 |
| 1891234126 | Center At Tucson, LLC | Skilled Nursing Facility | 5020 East Glen Street, Tucson, AZ 85712 | 2017-02-20 |
| 1770026361 | Lifestream Complete Senior Living, Inc. | Skilled Nursing Facility | 11521 W. Peoria Avenue, Youngtown, AZ 85363 | 2016-11-30 |
| 1760925358 | Lifestream Complete Senior Living, Inc. | Skilled Nursing Facility | 11523 W. Peoria Avenue, Youngtown, AZ 85363 | 2016-11-30 |
| 1043753635 | Lifestream Complete Senior Living, Inc. | Skilled Nursing Facility | 11527 W. Peoria Avenue, Suite 500, Youngtown, AZ 85363 | 2016-11-30 |
| Find all providers with the same taxonomy | ||||
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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.