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General NPI Number Information
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NPI Number | 1699289215
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Entity Type | Organization
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Legal Business Name | DESERT SPRINGS CARE HOME L.L.C.
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Dates
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Enumeration Date | 11/17/2017
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Last Update Date | 11/17/2017
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Provider Practice Location Address
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Address Line | 3445 W ACOMA DR
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City | PHOENIX
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State | AZ
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Zip | 85053-5620
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Country | US
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Telephone | 602-439-2734
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Fax | 602-843-1475
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Provider Business Mailing Address
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Address Line | 3445 W ACOMA DR
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City | PHOENIX
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State | AZ
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Zip | 85053-5620
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Country | US
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Telephone | 602-439-2734
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Fax | 602-843-1475
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Authorized Official
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Title or Position | OWNER/CAREGIVER
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Name | RODICA MERTIC
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Credential |
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Telephone | 602-403-3624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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