NPI 1336477520

The Harbor Lighhouse II

Organisation Adult Care Home Facility Glendale, AZ

Practice location

Address: 4142 W Grovers Ave, Glendale, AZ 85308-2926
Phone: (602) 358-8604
Fax: (602) 606-2356

Authorised official

Name: Costel Tirdea
Title: Owner
Phone: (602) 358-8604

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence ALH-6343 (AZ)

Other Custodial Care Facility providers in Arizona →

Registry record

NPI: 1336477520
Entity type: Organization
NPI issued: 26 Nov 2009
Record last updated: 26 Nov 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.