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General NPI Number Information
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NPI Number | 1134676562
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Entity Type | Organization
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Legal Business Name | UNOCHLOE HOME LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 15442 N.86TH LANE
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City | PEORIA
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State | AZ
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Zip | 85382
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Country | US
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Telephone | 623-296-0232
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Fax | 623-466-9784
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Provider Business Mailing Address
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Address Line | 15442 N.86TH LANE
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City | PEORIA
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State | AZ
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Zip | 85382
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Country | US
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Telephone | 623-296-0232
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Fax | 623-466-9784
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Authorized Official
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Title or Position | OWNER
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Name | MARCELO ACUTIN JR.
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Credential |
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Telephone | 623-296-0232
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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 | AL9386H
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License Number State | AZ
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