NPI | 1447645833 |
---|---|
Doing Business As | WEST LANE HOME |
Entity Type | Organization |
Authorized Contact | REBECCA T. SIDDIQUI Administrator 602-332-0780 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ AL9510H) |
Enumeration Date | 2015-04-02 |
Last Update Date | 2015-04-02 |