WILLOW CREEK ASSISTED LIVING & MEMORY CARE COMMUNITY
NPI 1154541324
Assisted Living Facility in Youngtown, AZ

Q: What is Phoenix Senior Living LLC's NPI number?

The NPI number for Phoenix Senior Living LLC is 1154541324. It was assigned to this organization in the NPPES registry on April 27, 2007. The provider is doing business as Willow Creek Assisted Living & Memory Care Community.

Q: What is Phoenix Senior Living LLC's specialty?

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

Active since April 27, 2007

12322 N 13TH AVENUE, YOUNGTOWN, AZ 85363(623) 583-2460(503) 485-1279 Get Directions Write a Review

NPPES record last updated: July 23, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Willow Creek Assisted Living & Memory Care Community NPPES

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

WILLOW CREEK ASSISTED LIVING & MEMORY CARE COMMUNITY (NPI 1154541324) is a healthcare organization registered as an assisted living facility in Youngtown, Arizona and active in the NPI registry since April 2007. The organization lists Jon M Harder, Manager, as its authorized official.

NPPES Registry Identity

NPI1154541324

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NamePHOENIX SENIOR LIVING LLC

Location Address12322 N 13TH AVENUEYoungtown, AZ 85363

Mailing AddressPo Box 3006Salem, OR 97302-0006 · (503) 485-8697 · Fax (503) 485-1279

Phone(623) 583-2460

Fax(503) 485-1279

Organization SubpartNo

Authorized OfficialJon M HarderManager · (503) 485-8697

Enumeration DateApril 27, 2007

Last NPPES UpdateJuly 23, 2008

✔ NPI 1154541324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in AZ · ALC5613

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.

Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X · License ALC5613 (AZ)

12322 N 13TH AVENUE, Youngtown, AZ 85363

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Other Names 1

Doing Business AsWillow Creek Assisted Living & Memory Care Community

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 Phoenix Senior Living LLC's NPI number?

The NPI number for Phoenix Senior Living LLC is 1154541324. It was assigned to this organization in the NPPES registry on April 27, 2007. The provider is doing business as Willow Creek Assisted Living & Memory Care Community.

Where is Phoenix Senior Living LLC located?

Phoenix Senior Living LLC is located at 12322 N 13th Avenue, Youngtown, AZ 85363. The listed phone number is (623) 583-2460.

What is Phoenix Senior 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 Phoenix Senior Living LLC was last updated on July 23, 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.