Provider Demographics
NPI:1942410253
Name:CHAPARRAL WINDS ASSISTED LIVING
Entity Type:Organization
Organization Name:CHAPARRAL WINDS ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELBA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:623-975-0880
Mailing Address - Street 1:16623 N WEST POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-6011
Mailing Address - Country:US
Mailing Address - Phone:623-975-0880
Mailing Address - Fax:623-975-6031
Practice Address - Street 1:16623 N WEST POINT PKWY
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-6011
Practice Address - Country:US
Practice Address - Phone:623-975-0880
Practice Address - Fax:623-975-6031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALC-4190310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility