Healthcare Provider Details

I. General information

NPI: 1417841107
Provider Name (Legal Business Name): WELL HEELED ADULT CARE SWEETWATER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6739 E SWEETWATER AVE
SCOTTSDALE AZ
85254-4586
US

IV. Provider business mailing address

6739 E SWEETWATER AVE
SCOTTSDALE AZ
85254-4586
US

V. Phone/Fax

Practice location:
  • Phone: 602-592-5391
  • Fax:
Mailing address:
  • Phone: 602-592-5391
  • 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: YANIRETH MONTIJO
Title or Position: MANAGER
Credential:
Phone: 602-592-5391