is a Assisted Living Facility in Mesa, Arizona. practices all healthcare services and medical treatments related to Assisted Living Facility. The NPI Number for is 1164631487. The last update date is .
's current location address is 6524 E Odessa St, Mesa, Arizona. You can contact this provider via phone number 4806121955 and fax number 4809243168. The mailing address for is 6524 E Odessa St, Mesa, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 6524 E Odessa St, Mesa, Arizona |
| Phone Number | 4806121955 |
| Fax Number | 4809243168 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1164631487 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 6524 E Odessa St |
|---|---|
| City | Mesa |
| State | Arizona (AZ) |
| Post Code | 852151060 |
| Phone Number | 4806121955 |
| Fax Number | 4809243168 |
Provider's Primary Taxonomy Detail
| Speciality | Assisted Living Facility |
|---|---|
| Taxonomy | 310400000X |
| Licence No | ALH5964 |
|
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. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| ALH5964 | AZ | ASSISTED GROUP HOME |
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