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General NPI Number Information
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NPI Number | 1013729151
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Entity Type | Organization
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Legal Business Name | MAJESTIC VILLA AL
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 8236 N 57TH DR
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City | GLENDALE
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State | AZ
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Zip | 85302-5906
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Country | US
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Telephone | 661-600-3435
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Fax |
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Provider Business Mailing Address
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Address Line | 10319 S 175TH AVE
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City | GOODYEAR
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State | AZ
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Zip | 85338-5503
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Country | US
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Telephone | 661-600-3435
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA BACCO
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Credential |
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Telephone | 661-600-3435
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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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