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PARADISE VALLEY
NPI 1912129040
Assisted Living Facility in Phoenix, AZ

Active since May 02, 2007CLIA 03D2332021 · Waiver
11645 NORTH 25TH PLACE, PHOENIX, AZ 85028(602) 992-0710(503) 485-1279 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Paradise Valley NPPES

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

PARADISE VALLEY (NPI 1912129040) is a healthcare organization registered as an assisted living facility in Phoenix, Arizona and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through October 12, 2027 and lists Jon Harder, Ceo President, as its authorized official.

NPPES Registry Identity

NPI1912129040
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePARADISE VALLEY
Location Address11645 NORTH 25TH PLACEPhoenix, AZ 85028
Mailing AddressPo Box 3006Salem, OR 97302 · (503) 486-8697 · Fax (503) 485-1279
Phone(602) 992-0710
Fax(503) 485-1279
Organization SubpartNo
Authorized OfficialJon HarderCeo President · (503) 485-8697
Enumeration DateMay 2, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1912129040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
11645 NORTH 25TH PLACE, Phoenix, AZ 85028
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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 03D2332021

Paradise Valley Internal Medicine And Consulting, PLLC · Phoenix, AZ
Active · expires Oct 12, 2027
CLIA Number03D2332021
Laboratory TypePhysician Office
Certificate Effective DateOctober 13, 2025
Certificate Expiration DateOctober 12, 2027
Laboratory DirectorDaniel Schlosser
Laboratory Phone(602) 922-3480
Laboratory LocationParadise Valley Internal Medicine And Consulting, PLLC3815 E Bell Rd Ste 4250, Phoenix, AZ 85032
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Paradise Valley's NPI number?

The NPI number for Paradise Valley is 1912129040. It was assigned to this organization in the NPPES registry on May 2, 2007.

Where is Paradise Valley located?

Paradise Valley is located at 11645 North 25th Place, Phoenix, AZ 85028. The listed phone number is (602) 992-0710.

What is Paradise Valley's specialty?

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

Does Paradise Valley hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2332021) is associated with this NPI, valid through October 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Paradise Valley was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.