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General NPI Number Information
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NPI Number | 1013492412
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Entity Type | Organization
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Legal Business Name | PLEASANT SUNSET ASSISTED LIVING LLC
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 10/02/2018
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Provider Practice Location Address
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Address Line | 21393 N 94TH AVE
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City | PEORIA
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State | AZ
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Zip | 85382-8300
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Country | US
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Telephone | 602-577-3163
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Fax | 623-215-4261
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Provider Business Mailing Address
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Address Line | 21393 N 94TH AVE
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City | PEORIA
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State | AZ
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Zip | 85382-8300
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Country | US
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Telephone | 602-577-3163
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Fax | 623-215-4261
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Authorized Official
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Title or Position | STATUTORY AGENT/MANAGER
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Name | ALEXANDRA CAIENAR
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Credential |
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Telephone | 602-577-3163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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