Doctor Name: | TIMOTHY PAVLAKES |
NPI Number: | 1053665984 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | AL8784H |
Business Practice Address: | 5133 W Fawn Dr Laveen, AZ - 853392898 |
Business Phone Number: | 6027107166 |
Business Fax Number: | 6024412553 |
Mailing Address: | 5133 W Fawn Dr, LAVEEN |
State: | AZ |
Postal Code: | 853392898 |
Phone Number: | 6027107166 |
Fax Number: | 6024412553 |
NPI Enumeration Date: | 10/30/2012 |
NPI Last Update Date: | 10/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311ZA0620X |
License Number: | AL8784H |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Custodial Care Facility |
Taxonomy Specialization: | Adult Care Home |
Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |