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General NPI Number Information
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NPI Number | 1801698097
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Entity Type | Individual
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Provider Name | ANGIE SILASI
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Gender | Female
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 14836 N HANA MAUI DR
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City | PHOENIX
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State | AZ
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Zip | 85022-3657
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Country | US
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Telephone | 602-291-3610
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Fax | 480-452-1596
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Provider Business Mailing Address
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Address Line | 25107 N 11TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85085-2916
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Country | US
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Telephone | 602-291-3610
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AL13290H
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License Number State | AZ
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