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General NPI Number Information
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NPI Number | 1578067757
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Entity Type | Organization
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Legal Business Name | DOUBLETREE RANCHOS ASSISTED LIVING, LLC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 5706 E HORSESHOE RD
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-2249
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Country | US
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Telephone | 601-369-0874
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Fax | 602-867-0539
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Provider Business Mailing Address
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Address Line | 17032 N 58TH WAY
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-5921
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Country | US
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Telephone | 602-369-0874
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Fax | 602-867-0539
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. LINDA ANN MEGYESI
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Credential |
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Telephone | 602-369-0874
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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 | AL875OH
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License Number State | AZ
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