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General NPI Number Information
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NPI Number | 1235936287
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Entity Type | Organization
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Legal Business Name | MORNING GLORY ADULT CARE HOME LLC 1
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 6725 N AMAHL DR
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City | TUCSON
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State | AZ
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Zip | 85704-1208
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Country | US
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Telephone | 520-638-5580
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Fax | 520-989-9927
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Provider Business Mailing Address
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Address Line | 6725 N AMAHL DR
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City | TUCSON
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State | AZ
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Zip | 85704-1208
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Country | US
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Telephone | 520-638-5580
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Fax | 520-989-9927
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | SHELLY ANN RODRIGUEZ
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Credential |
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Telephone | 520-235-1328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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