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General NPI Number Information
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NPI Number | 1609947845
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Entity Type | Organization
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Legal Business Name | GOOD NEIGHBOR ASSISTED LIVING SERVICES INC
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 15655 W ROOSEVELT PKWY SUITE 213
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City | GOODYEAR
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State | AZ
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Zip | 85338-9282
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Country | US
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Telephone | 623-932-4878
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Fax | 623-850-9985
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Provider Business Mailing Address
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Address Line | 15655 W ROOSEVELT PKWY SUITE 213
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City | GOODYEAR
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State | AZ
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Zip | 85338-9282
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Country | US
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Telephone | 623-932-4878
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Fax | 623-850-9985
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Authorized Official
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Title or Position | CFO
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Name | MR. ARTHUR P. DE MARAH
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Credential | CPA
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Telephone | 623-932-4878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | AZ
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