NPI 1053539700

Surprise Residential Assisted Living

Organisation Assisted Living Facility Surprise, AZ

Practice location

Address: 17218 W Statler St, Surprise, AZ 85388-1265
Phone: (602) 369-1254
Fax: (602) 595-1659
Mailing address: 17633 N 14th St, Phoenix, AZ 85022-2001

Authorised official

Name: Shaiba Barry
Title: Manager
Phone: (602) 404-8196

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1053539700
Entity type: Organization
NPI issued: 20 Apr 2007
Record last updated: 22 Aug 2020

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.