NPI 1114296332

Life Sonoran Homnes

Organisation Adult Care Home Facility Mesa, AZ

Practice location

Address: 2036 E Calle Maderas, Mesa, AZ 85213-2910
Phone: (480) 650-6685
Fax: (480) 461-0069
Mailing address: PO Box 8998, Mesa, AZ 85214-8998

Authorised official

Name: Mike Fitzgerald
Title: Manager
Phone: (480) 650-6685

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

Other Custodial Care Facility providers in Arizona →

Registry record

NPI: 1114296332
Entity type: Organization
NPI issued: 16 Dec 2011
Record last updated: 16 Dec 2011

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.