Healthcare Provider Details

I. General information

NPI: 1891628442
Provider Name (Legal Business Name): SOL LIVING HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5509 N 193RD AVE
LITCHFIELD PARK AZ
85340-6564
US

IV. Provider business mailing address

5501 N 74TH DR
GLENDALE AZ
85303-5230
US

V. Phone/Fax

Practice location:
  • Phone: 602-884-7014
  • Fax:
Mailing address:
  • Phone: 602-884-7014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MARISOL C BENAVIDES
Title or Position: OWNER
Credential:
Phone: 602-884-7014