NPI 1043928112

Victoria Bravo, OWNER

Practitioner Assisted Living Facility Phoenix, AZ

Practice location

Address: 4315 W Earll Dr, Phoenix, AZ 85031-3819
Phone: (714) 501-8772
Mailing address: 16470 N 182nd Ln, Surprise, AZ 85388-6620

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1043928112
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Nov 2022
Record last updated: 8 Nov 2022

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.