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General NPI Number Information
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NPI Number | 1619830148
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Entity Type | Organization
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Legal Business Name | GABRIEL'S COMFORT HAVEN LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 3220 N CRAYCROFT RD UNIT 1
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City | TUCSON
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State | AZ
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Zip | 85712-5208
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Country | US
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Telephone | 520-843-0778
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Fax | 520-210-7357
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Provider Business Mailing Address
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Address Line | 12671 N ELLSBURY LN
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City | MARANA
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State | AZ
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Zip | 85653-1438
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Country | US
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Telephone | 520-843-0778
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Fax | 520-210-7357
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LEAH WANGETHA
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Credential |
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Telephone | 520-843-0778
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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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