NPI 1033571419
An Enchanted Assisted Living LLC
Practice location
- Address
- 15924 W Mauna Loa Ln, Surprise, AZ 85379
- Phone
- (602) 550-6653
- Mailing address
- 15924 W Mauna Loa Ln, Surprise, AZ 85379-5141
Authorised official
- Name
- Stefan Magda
- Title
- Ceo
- Phone
- (602) 550-6653
Registered specialties
Assisted Living Facility
Primary
Registry record
- NPI
- 1033571419
- Entity type
- Organization
- NPI issued
- 24 Mar 2016
- Record last updated
- 24 Mar 2016
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.