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General NPI Number Information
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NPI Number | 1851099485
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Entity Type | Organization
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Legal Business Name | BROTHERS ASISSTED LIVING HOME LLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 690 N CORDOBA AVE
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City | CHANDLER
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State | AZ
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Zip | 85226-2302
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Country | US
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Telephone | 520-238-1386
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Fax |
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Provider Business Mailing Address
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Address Line | 690 N CORDOBA AVE
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City | CHANDLER
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State | AZ
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Zip | 85226-2302
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Country | US
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Telephone | 520-238-1386
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. ANOUMOU DALMAIDA
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Credential |
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Telephone | 520-238-1386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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