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General NPI Number Information
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NPI Number | 1770121337
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Entity Type | Organization
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Legal Business Name | A PLACE LIKE HOME INC
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 45646 W LONG WAY
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City | MARICOPA
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State | AZ
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Zip | 85139-7070
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Country | US
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Telephone | 773-710-8829
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Fax | 480-470-3630
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Provider Business Mailing Address
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Address Line | 45646 W LONG WAY
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City | MARICOPA
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State | AZ
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Zip | 85139-7070
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Country | US
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Telephone | 480-500-8462
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Fax | 480-470-3630
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Authorized Official
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Title or Position | CEO EXCUTIVE DIRECTOR
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Name | SHAUNTINA R MCLAURIN
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Credential |
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Telephone | 480-500-8462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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