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General NPI Number Information
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NPI Number | 1154669448
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Entity Type | Organization
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Legal Business Name | ASSISTED LIVING AT BLOOMFIELD MANOR INC.
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 5815 E AIRE LIBRE AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-9221
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Country | US
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Telephone | 480-922-3299
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 E GREENWAY PKWY 103-505
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-2065
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Country | US
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Telephone | 480-580-1650
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Fax | 480-607-5444
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MR. ZANELY ROXAS ZARAGOZA
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Credential |
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Telephone | 480-922-3299
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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 | AL4808H
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License Number State | AZ
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