NPI 1619047305

St. Michael's Manor

Organisation Adult Care Home Facility Peoria, AZ

Practice location

Address: 8449 W Shaw Butte Dr, Peoria, AZ 85345-8160
Phone: (623) 486-5987
Fax: (623) 328-5530

Authorised official

Name: Teresita Arcena Cabacungan
Title: Owner
Phone: (562) 673-3214

Registered specialties (3)

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence ALH-4384 (AZ)

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Registry record

NPI: 1619047305
Entity type: Organization
NPI issued: 9 Nov 2006
Record last updated: 31 May 2008

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.