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General NPI Number Information
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NPI Number | 1114143294
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Entity Type | Organization
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Legal Business Name | GARDEN TERRACE, LLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 S CHAPARRAL CIR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-4204
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Country | US
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Telephone | 520-459-0005
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Fax | 520-459-8461
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Provider Business Mailing Address
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Address Line | 1100 S CHAPARRAL CIR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-4204
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Country | US
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Telephone | 520-459-0005
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Fax | 520-459-8461
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Authorized Official
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Title or Position | ADMINISTRATOR - OWNER
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Name | MR. DANIEL PARROTTA
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Credential |
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Telephone | 520-459-0005
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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 | ALH-5896
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License Number State | AZ
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