Healthcare Provider Details

I. General information

NPI: 1720990773
Provider Name (Legal Business Name): CIARA WARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 E BROADWAY AVE
APACHE JUNCTION AZ
85119-5301
US

IV. Provider business mailing address

1510 E BROADWAY AVE
APACHE JUNCTION AZ
85119-5301
US

V. Phone/Fax

Practice location:
  • Phone: 602-475-0135
  • Fax: 602-275-0085
Mailing address:
  • Phone: 602-475-0135
  • Fax: 602-275-0085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALC20048
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: