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General NPI Number Information
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NPI Number | 1407253685
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Entity Type | Organization
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Legal Business Name | HAPPY FOSTER FAMILY ADULT CARE HOME, LLC
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 2421 E CAIRO DR
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City | TEMPE
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State | AZ
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Zip | 85282-4112
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Country | US
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Telephone | 480-307-6033
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Fax | 480-307-6033
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Provider Business Mailing Address
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Address Line | 2421 E CAIRO DR
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City | TEMPE
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State | AZ
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Zip | 85282-4112
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Country | US
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Telephone | 480-307-6033
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Fax | 480-307-6033
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN FORTE
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Credential |
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Telephone | 602-791-1030
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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 | AL8550H
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License Number State | AZ
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