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General NPI Number Information
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NPI Number | 1861949612
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Entity Type | Organization
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Legal Business Name | RENATA'S HOME FOR THE ELDERLY # 2 INC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 31392 N SUNFLOWER WAY
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-4330
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Country | US
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Telephone | 148-030-4292
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Fax | 148-027-5832
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Provider Business Mailing Address
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Address Line | 31392 N SUNFLOWER WAY
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-4330
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Country | US
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Telephone | 148-030-4292
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Fax | 148-027-5832
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Authorized Official
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Title or Position | MANAGER
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Name | MS. RENATA SWEDROWSKA
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Credential |
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Telephone | 14803042922
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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 | AL8420H
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License Number State | AZ
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