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General NPI Number Information
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NPI Number | 1942410253
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Entity Type | Organization
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Legal Business Name | CHAPARRAL WINDS ASSISTED LIVING
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16623 N WEST POINT PKWY
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City | SURPRISE
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State | AZ
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Zip | 85374-6011
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Country | US
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Telephone | 623-975-0880
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Fax | 623-975-6031
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Provider Business Mailing Address
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Address Line | 16623 N WEST POINT PKWY
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City | SURPRISE
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State | AZ
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Zip | 85374-6011
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Country | US
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Telephone | 623-975-0880
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Fax | 623-975-6031
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MELBA JOYCE WHITE
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Credential | LPN
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Telephone | 623-975-0880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALC-4190
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License Number State | AZ
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