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General NPI Number Information
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NPI Number | 1407287774
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Entity Type | Organization
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Legal Business Name | ADRIAN ASSISTED LIVING
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 607 W VILLA RITA DR
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City | PHOENIX
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State | AZ
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Zip | 85023-8103
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Country | US
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Telephone | 602-687-3804
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Fax | 602-595-0604
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Provider Business Mailing Address
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Address Line | 607 W VILLA RITA DR
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City | PHOENIX
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State | AZ
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Zip | 85023-8103
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Country | US
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Telephone | 602-687-3804
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Fax | 602-595-0604
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Authorized Official
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Title or Position | ASSISTED LIVING MANAGER
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Name | ADRIANA CAMELIA CIRJAN
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Credential |
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Telephone | 602-595-0604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | AL8935H
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License Number State | AZ
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