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General NPI Number Information
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NPI Number | 1427826338
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Entity Type | Organization
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Legal Business Name | FREEDOM CARE AT BELLA VISTA LLC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 17898 N BELL POINTE BLVD
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City | SURPRISE
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State | AZ
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Zip | 85374-3961
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Country | US
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Telephone | 928-252-1037
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Fax |
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Provider Business Mailing Address
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Address Line | 20554 W BRIARWOOD DR
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City | BUCKEYE
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State | AZ
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Zip | 85396-1836
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Country | US
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Telephone | 650-704-0541
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RILEY QUINLAN
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Credential |
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Telephone | 650-704-0541
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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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