Organization Name: | ILHC OF PHOENIX, LLC |
NPI Number: | 1902983265 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELAINE R. BURTON (PRESIDENT & CHAIR OF BD OF MANAGERS) |
Mailing Address: | 4602 N 24th St Phoenix |
State: | AZ US |
Postal Code: | 850165253 |
Phone Number: | 6029549178 |
Fax Number: | 6025538344 |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 12/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | ALC-5695 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |