Provider Demographics
NPI:1376225722
Name:LUMEN CHRISTI OF ARIZONA LLC
Entity Type:Organization
Organization Name:LUMEN CHRISTI OF ARIZONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:VALENTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AIKHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-338-4284
Mailing Address - Street 1:2436 W TONTO ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85009-5804
Mailing Address - Country:US
Mailing Address - Phone:757-338-4284
Mailing Address - Fax:
Practice Address - Street 1:2436 W TONTO ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85009-5804
Practice Address - Country:US
Practice Address - Phone:757-338-4284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility