NPI 1194861716

Pavilion Guest Home

Organisation Adult Care Home Facility Mesa, AZ

Practice location

Address: 2955 E Mallory St, Mesa, AZ 85213-1667
Phone: (480) 654-8329
Fax: (480) 830-4113
Mailing address: 2955 E. Mallory St., Mesa, AZ 85213

Authorised official

Name: Marieta G. Hugo
Title: Owner
Phone: (480) 654-8329

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence ALH 4489 (AZ)

Other Custodial Care Facility providers in Arizona →

Registry record

NPI: 1194861716
Entity type: Organization
NPI issued: 30 Jan 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.