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NINA NETTLES
NPI 1124165469
Assisted Living Facility - Assisted Living, Mental Illness in Phoenix, AZ

Active since January 30, 2007
3643 E EMILE ZOLA AVE, PHOENIX, AZ 85032(602) 867-7500 Get Directions Write a Review

NPPES record last updated: June 16, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nina Nettles NPPES

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

NINA NETTLES (NPI 1124165469) is a healthcare organization registered as an assisted living, mental illness in Phoenix, Arizona and active in the NPI registry since January 2007. The organization lists Nina Fae Nettles, Administrator, as its authorized official.

NPPES Registry Identity

NPI1124165469
Entity TypeOrganization
Primary Taxonomy3104A0625X
Legal Business NameNINA NETTLES
Location Address3643 E EMILE ZOLA AVEPhoenix, AZ 85032-6219
Mailing Address3643 E Emile Zola AvePhoenix, AZ 85032-6219 · (602) 867-7500
Phone(602) 867-7500
Organization SubpartNo
Authorized OfficialNina Fae NettlesAdministrator · (602) 867-7500
Enumeration DateJanuary 30, 2007
Last NPPES UpdateJune 16, 2008
✔ NPI 1124165469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities
Taxonomy Code3104A0625X
License✔ Licensed in AZ · BH2458
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
3643 E EMILE ZOLA AVE, Phoenix, AZ 85032
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Other Identifiers 2

OtherBH2458AZ · State Licence
Medicaid873936AZ

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 Nina Nettles's NPI number?

The NPI number for Nina Nettles is 1124165469. It was assigned to this organization in the NPPES registry on January 30, 2007.

Where is Nina Nettles located?

Nina Nettles is located at 3643 E Emile Zola Ave, Phoenix, AZ 85032. The listed phone number is (602) 867-7500.

What is Nina Nettles's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

When was this NPI record last updated?

The NPPES record for Nina Nettles was last updated on June 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.