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General NPI Number Information
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NPI Number | 1023658127
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Entity Type | Organization
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Legal Business Name | CAREFREE MANOR ASSISTED LIVING LLC
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 7886 E BREATHLESS DR
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City | CAREFREE
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State | AZ
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Zip | 85377
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Country | US
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Telephone | 623-698-2322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 910
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City | CAREFREE
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State | AZ
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Zip | 85377-0910
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Country | US
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Telephone | 623-698-2322
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Fax | 480-595-3175
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Authorized Official
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Title or Position | ADMIMISTRATOR
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Name | LUCY ANGELINA CARRASCO
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Credential | OWNER
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Telephone | 623-698-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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