Healthcare Provider Details

I. General information

NPI: 1992194609
Provider Name (Legal Business Name): ORION HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2015
Last Update Date: 01/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6713 W BLOOMFIELD RD
PEORIA AZ
85381-9591
US

IV. Provider business mailing address

8615 W KELTON LN STE 309
PEORIA AZ
85382-4758
US

V. Phone/Fax

Practice location:
  • Phone: 602-466-3223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License NumberAL9500H
License Number StateAZ

VIII. Authorized Official

Name: MOISES PEREZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 602-466-3223