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General NPI Number Information
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NPI Number | 1023302627
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Entity Type | Organization
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Legal Business Name | PHILIPPINE FAMILY CARE HOMES LLC
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | 1256 E ELM RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85140-3200
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Country | US
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Telephone | 480-677-3471
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Fax |
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Provider Business Mailing Address
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Address Line | 18567 E OLD BEAU TRL
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-3516
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Country | US
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Telephone | 480-205-1663
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. MYRNA MALIMBAN
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Credential | MBA
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Telephone | 480-205-1663
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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 | ALH5502
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License Number State | AZ
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