BOULDER GARDENS ASSISTANT LIVING, LLC
NPI 1114262292
Assisted Living Facility in Prescott, AZ

Q: What is Boulder Gardens Assistant Living, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since November 30, 2012

860 DOUGHERTY ST, PRESCOTT, AZ 86305(928) 778-9667(520) 393-1044 Get Directions Write a Review

NPPES record last updated: November 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Boulder Gardens Assistant Living, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOULDER GARDENS ASSISTANT LIVING, LLC (NPI 1114262292) is a healthcare organization registered as an assisted living facility in Prescott, Arizona and active in the NPI registry since November 2012. The organization lists Carl Zimmerman, Senior Vice President, as its authorized official.

NPPES Registry Identity

NPI1114262292

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameBOULDER GARDENS ASSISTANT LIVING, LLC

Location Address860 DOUGHERTY STPrescott, AZ 86305-1841

Mailing Address150 N La Canada DrGreen Valley, AZ 85614-3129 · (520) 352-3018 · Fax (520) 393-1044

Phone(928) 778-9667

Fax(520) 393-1044

Organization SubpartNo

Authorized OfficialCarl ZimmermanSenior Vice President · (520) 352-3019

Enumeration DateNovember 30, 2012

✔ NPI 1114262292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in AZ · AL1494C

Definition

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.

860 DOUGHERTY ST, Prescott, AZ 86305

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Other Identifiers 1

OtherAL1494CAZ · State License

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHWESTERN MEDICAL CENTERS-AZ, INC.

Assisted Living Facility

860 DOUGHERTY ST
PRESCOTT, AZ 86305

Yavapai County (928) 778-9777

HAVEN HEALTH PRESCOTT ALF LLC

Assisted Living Facility

860 DOUGHERTY ST
PRESCOTT, AZ 86305

Yavapai County (928) 778-9777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boulder Gardens Assistant Living, LLC's NPI number?

The NPI number for Boulder Gardens Assistant Living, LLC is 1114262292. It was assigned to this organization in the NPPES registry on November 30, 2012.

Where is Boulder Gardens Assistant Living, LLC located?

Boulder Gardens Assistant Living, LLC is located at 860 Dougherty St, Prescott, AZ 86305. The listed phone number is (928) 778-9667.

What is Boulder Gardens Assistant Living, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Boulder Gardens Assistant Living, LLC was last updated on November 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.