Healthcare Provider Details

I. General information

NPI: 1679337869
Provider Name (Legal Business Name): RICHMOND HILLS ALF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 E SANDRA TER
PHOENIX AZ
85022-2690
US

IV. Provider business mailing address

1141 E SANDRA TER
PHOENIX AZ
85022-2690
US

V. Phone/Fax

Practice location:
  • Phone: 480-510-2188
  • Fax: 602-285-0161
Mailing address:
  • Phone: 480-510-2188
  • Fax: 602-285-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ANTOANETA DINCA
Title or Position: MANAGER
Credential:
Phone: 480-510-2188