NPI 1164606620

Vineyard Adult Care Home

Organisation Adult Care Home Facility Glendale, AZ

Practice location

Address: 4415 W Carol Ave, Glendale, AZ 85302-3814
Phone: (623) 847-1216
Fax: (623) 847-1216

Authorised official

Name: Cornelia Lupas
Title: Administrator
Phone: (623) 847-1216

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence ALH-6842 (AZ)

Other Custodial Care Facility providers in Arizona →

Registry record

NPI: 1164606620
Entity type: Organization
NPI issued: 19 Dec 2007
Record last updated: 29 Jan 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.