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General NPI Number Information
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NPI Number | 1982846333
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Entity Type | Organization
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Legal Business Name | THOMPSON PEEK SENIOR CARE HOME, LLC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 9742 E GELDING DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3883
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Country | US
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Telephone | 480-614-5410
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Fax |
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Provider Business Mailing Address
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Address Line | 9742 E GELDING DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3883
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Country | US
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Telephone | 480-614-5410
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Fax |
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Authorized Official
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Title or Position | OWNER/CAREGIVER
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Name | MARY VLAD
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Credential |
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Telephone | 480-614-5410
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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 | ALH6873
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License Number State | AZ
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