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General NPI Number Information
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NPI Number | 1770026635
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Entity Type | Organization
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Legal Business Name | SDANCEL MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 15724 N 168TH LN
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City | SURPRISE
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State | AZ
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Zip | 85388-1349
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Country | US
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Telephone | 623-755-5359
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Fax | 623-322-1968
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Provider Business Mailing Address
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Address Line | 15724 N 168TH LN
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City | SURPRISE
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State | AZ
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Zip | 85388-1349
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Country | US
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Telephone | 623-755-5359
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Fax | 623-322-1968
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Authorized Official
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Title or Position | OWNER
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Name | MR. SANTOS CAINTIC DANCEL
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Credential |
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Telephone | 623-755-5359
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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 | AL9154H
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License Number State | AZ
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