BENEVILLA - NPI 1144675307 - Clinic/Center in Surprise, AZ

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QA0600X and a focus in Adult Day Care.

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About Benevilla NPPES

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

BENEVILLA (NPI 1144675307) is a healthcare organization registered as an adult day care in Surprise, Arizona and active in the NPI registry since April 2016. The organization holds a CLIA Waiver certificate valid through December 13, 2026 and lists Joanne Thomson, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1144675307

Entity TypeOrganization

Primary Taxonomy261QA0600X

Legal Business NameSUN CITY AREA INTERFAITH SERVICES, INC

Location Address16752 N GREASEWOOD STSurprise, AZ 85378-3639

Mailing AddressPo Box 8450Surprise, AZ 85374-0124 · (623) 584-4999

Phone(623) 584-4999

Organization SubpartNo

Authorized OfficialJoanne ThomsonPresident/ceo · (623) 584-4999

Enumeration DateApril 25, 2016

Last NPPES UpdateJanuary 22, 2024

NPPES CertifiedJanuary 22, 2024

✔ NPI 1144675307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Day CareAmbulatory Health Care Facilities

Taxonomy Code261QA0600X

Licenses✔ Licensed in AZ · AL7567D✔ Licensed in AZ · AL1083D✔ Licensed in AZ · AL2905D

16752 N GREASEWOOD ST, Surprise, AZ 85378

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Other Names 1

Doing Business AsBenevilla

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D1062453

Benevilla · Surprise, AZ

Active · expires Dec 13, 2026

CLIA Number03D1062453

Laboratory TypeOther

Certificate Effective DateDecember 14, 2024

Certificate Expiration DateDecember 13, 2026

Laboratory DirectorCourtney Allen

Laboratory Phone(623) 584-4999

Laboratory LocationBenevilla16752 N Greasewood St, Surprise, AZ 85374

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

SHERRY WAGONER

Registered Nurse (Community Health)