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General NPI Number Information
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NPI Number | 1285524280
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Entity Type | Organization
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Legal Business Name | MATEENAH'S MANOR ASSISTED LIVING HOMES, LLC
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 4515 W PEARCE RD
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City | LAVEEN
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State | AZ
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Zip | 85339-7784
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Country | US
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Telephone | 602-432-8319
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Fax |
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Provider Business Mailing Address
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Address Line | 139 S 108TH DR
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City | AVONDALE
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State | AZ
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Zip | 85323-3306
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Country | US
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Telephone | 602-432-8319
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. SANDRA MUHAMMAD
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Credential |
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Telephone | 602-432-8319
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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 |
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License Number State |
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