SKYLARK ACH LLC


Address: 12034 N 46th Ln, Glendale, AZ 85304-3012
Phone: 6237761477

SKYLARK ACH LLC (NPI# 1952781247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952781247
Entity Type Organization
Organization Name SKYLARK ACH LLC
Practice Address 12034 N 46th Ln
Glendale
AZ 85304-3012
Practice Telephone 6237761477
Mailing Telephone 6237761477
Enumeration Date 2015-06-02
Last Update Date 2015-06-02
Authorized Official Name PAUL V PETRINI (OWNER)
Authorized Official Telephone 6024863001
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 3104A0625X Assisted Living Facility
Specialization: Assisted Living, Mental Illness
Nursing & Custodial Care Facilities
N 3104A0630X Assisted Living Facility
Specialization: Assisted Living, Behavioral Disturbances
Nursing & Custodial Care Facilities
Y 310400000X Assisted Living Facility Nursing & Custodial Care Facilities

Office Location

Street Address 12034 N 46TH LN
City GLENDALE
State AZ
Zip Code 85304-3012

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NPI Name Taxonomy Address Enumeration
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1962929224 Glendale Surgery Center Clinic/Center 11851 North 51st Ave, Suite G, Glendale, AZ 85304 2017-08-28
1073941092 Megan Lorenzen Occupational Therapist 5834 W. Bloomfield Rd., Glendale, AZ 85304 2013-10-30
1396178380 Danielle Marie Wiles Registered Nurse 12901 W. 63rd Avenue, Glendale, AZ 85304 2013-08-14
1780017848 Pedram Nazari Pharmacist 4811 North 83rd Avenue, Glendale, AZ 85304 2013-08-13
1740558022 Krunal Patel Obstetrics & Gynecology 5605 W Eugie Ave Ste 111, Glendale, AZ 85304 2011-12-01
1730499609 Laura A Truax Physician Assistant 11851 N. 51st Ave, Ste F-110, Glendale, AZ 85304 2010-10-13
1760698419 Suhir Bitar Pediatrics 13625 N 59th Ave, Glendale, AZ 85304 2007-05-16
1497967293 Pam Rubbone Psychologist 4650 West Sweetwater Ave., Glendale, AZ 85304 2007-05-04
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Taxonomy Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1952954489 Jubilee In The Desert, LLC Assisted Living Facility 4321 W Cholla St, Glendale, AZ 85304-3531 2019-07-23
1962054536 Vema Corporation Assisted Living Facility 4802 W Gelding Dr, Glendale, AZ 85306-4438 2019-07-12
1013487180 Ludovica Rodica Malutan Assisted Living Facility 5019 W Paradise Ln, Glendale, AZ 85306-2655 2018-11-30
1144790601 Terra Pointe Care, LLC Assisted Living Facility 5330 W Union Hills Dr, Glendale, AZ 85308-1311 2018-11-27
1316433493 Andrei Martin Assisted Living Facility 6338 W Port Royale Ln, Glendale, AZ 85306-3260 2018-07-02
1841782638 Goldwater Legacy Assisted Living LLC Assisted Living Facility 6640 W Pinnacle Peak Rd, Glendale, AZ 85310-3409 2018-06-06
1932627494 Dennis J Tan Assisted Living Facility 6979 W Cactus Wren Dr, Glendale, AZ 85303-2684 2017-09-05
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Competitor

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City GLENDALE
Zip Code 85304

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Dataset Information

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.

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