NPI 1013244037

Renaissance Assisted Living

Organisation Assisted Living Facility Laveen, AZ

Practice location

Address: 4409 W Coplan Farms Rd, Laveen, AZ 85339-7132
Phone: (602) 999-7685

Authorised official

Name: Sebastian Smith
Title: Owner
Phone: (602) 999-7685

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence AL7740H (AZ)

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Registry record

NPI: 1013244037
Entity type: Organization
NPI issued: 12 Nov 2009
Record last updated: 12 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.