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General NPI Number Information
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NPI Number | 1093406142
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Entity Type | Organization
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Legal Business Name | CARING SOULS COMMUNITY LLC
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 41920 W SUNLAND DR
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City | MARICOPA
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State | AZ
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Zip | 85138-2245
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Country | US
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Telephone | 414-699-8462
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Fax |
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Provider Business Mailing Address
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Address Line | 41920 W SUNLAND DR
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City | MARICOPA
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State | AZ
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Zip | 85138-2245
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Country | US
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Telephone | 414-699-8462
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. THERETA DURRAH
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Credential |
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Telephone | 414-699-8462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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