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General NPI Number Information
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NPI Number | 1588241376
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Entity Type | Organization
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Legal Business Name | TERRAVELLA ASSISTED LIVING CARE LLC
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 20930 E REINS RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-3797
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Country | US
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Telephone | 480-648-3576
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Fax | 602-767-3498
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Provider Business Mailing Address
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Address Line | 955 E HOLLAND PARK DR
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City | GILBERT
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State | AZ
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Zip | 85297-0028
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Country | US
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Telephone | 480-562-0289
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Fax | 602-767-3498
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Authorized Official
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Title or Position | CAREGIVER
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Name | QUNYING WEI
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Credential |
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Telephone | 480-648-3576
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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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