Vista South Assisting Living

NPI 1194866277 - Assisted Living Facility - 310400000X

NPI Details
NPI 1194866277
Enumeration Date 02/09/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KENNETH RAY KENNETH
Position OWNER
Phone (602) 435-3808
Fax (602) 276-1854
Practice Location
1010 E SOUTHERN AVE BLDG 2
PHOENIX AZ, 85040-5108, US
Phone (602) 435-3808
Fax (602) 276-1854
Business Location
1010 E SOUTHERN AVE BLDG 2
PHOENIX AZ, 85040-5108, US
Phone (602) 435-3808
Fax (602) 276-1854
Toxanomy
Taxonomy Code 310400000X
License State Arizona
License Number ALH5881
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According to our database, Vista South Assisting Living NPI is 1194866277, taxonomy code is 310400000X and license number is ALH5881, license state is located at Arizona. Vista South Assisting Living physically located at 1010 E Southern Ave Bldg 2, Phoenix AZ, 85040-5108. NPI Number 1033115704 has the healthcare provider type.

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1194866277 NPI number is provided on an as is basis without warranty of any kind. 1194866277 is maintained by the National Plan & Provider Enumeration System. The contents of Vista South Assisting Living are for informational purposes only.