Agua Fria Senior Living, Llc, NPI 1912536368
Assisted Living Facility in Peoria, AZ, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1912536368
NPI Entity Type Organization
Provider Name Agua Fria Senior Living, Llc
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 8880 N 107th Ave, Peoria, AZ, US
Provider Mailing Address 14650 N 78th Way Ste B, Scottsdale, AZ, US, 852602970
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name Douglas Hamilton
Official Position MANAGING MEMBER
Phone 480-368-5755

Primary Taxonomy

Taxonomy Code

310400000X

Taxonomy Name Assisted Living Facility
Classification

Assisted Living Facility

Group

Nursing & Custodial Care Facilities

Description 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.

Other Organization Name

The Mission at Agua Fria
Doing Business As

Business Address

Agua Fria Senior Living, Llc
8880 N 107th Ave

Peoria, AZ, US

Phone: 623-266-0999
Fax: 623-215-7703

Mailing Address

Agua Fria Senior Living, Llc
14650 N 78th Way Ste B
Scottsdale, AZ, US
ZIP 852602970
Phone: 602-544-3195
Fax: 602-553-7574

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
527346 AZ MEDICAID 05
AL10709C AZ ARIZONA DEPARTMENT OF HEALTH SERVICES 01

Other Providers in AZ, US

NPI Name Taxonomy Address

1659836476

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Mental Health Clinic/Center (Including Community Mental Health Center)

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MRS. LCSW Colette Reon Hardesty-tesar X

Individual

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MD Xiao Kristin Liang

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RD Haley Dawn Smith

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1851852834

MD Nicole Marie Casey

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Julie Ann Roberts

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MOT OTR/L, BCP, CIMI Victoria Wicus

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LCSW Taylor Redding

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Sierra Vista Regional Health Center Medical Group Llc

Organization

Family Medicine Physician

5750 E Highway 90

Suite 200

Sierra Vista, AZ

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PT Catherine Broadbent

Individual

Physical Therapist

23374 W Yuma Rd Ste 104

Buckeye, AZ

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