Organization Name: | LASHANNA D ROE |
NPI Number: | 1144360512 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LASHANNA D ROE (OWNER) |
Mailing Address: | 11596 W Purdue Ave Youngtown |
State: | AZ US |
Postal Code: | 853631732 |
Phone Number: | 6233884647 |
Fax Number: | 6232669680 |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 06/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311ZA0620X |
License Number: | ALH5220 |
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. |