Healthcare Provider Details

I. General information

NPI: 1114838745
Provider Name (Legal Business Name): KIND HEARTZ ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14018 N PALM ST
EL MIRAGE AZ
85335-7008
US

IV. Provider business mailing address

14018 N PALM ST
EL MIRAGE AZ
85335-7008
US

V. Phone/Fax

Practice location:
  • Phone: 480-306-6289
  • Fax:
Mailing address:
  • Phone: 480-306-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHANTRELL THOMAS
Title or Position: OWNER
Credential:
Phone: 602-316-4327