Provider Demographics
NPI:1144360512
Name:WHISPERING WATERS LLC
Entity type:Organization
Organization Name:WHISPERING WATERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHANNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-570-1521
Mailing Address - Street 1:11596 W PURDUE AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1732
Mailing Address - Country:US
Mailing Address - Phone:623-388-4647
Mailing Address - Fax:623-266-9680
Practice Address - Street 1:11596 W PURDUE AVE
Practice Address - Street 2:
Practice Address - City:YOUNGTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85363-1732
Practice Address - Country:US
Practice Address - Phone:623-388-4647
Practice Address - Fax:623-266-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH5220311ZA0620X
311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home