TOM PLIVATUS ISHENGOMA

GLENDALE, AZ
NPI1558135574
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy310400000X Assisted Living Facility
Enumeration Date2023-11-09
Last Update Date2023-11-09
Business Address
TOM PLIVATUS ISHENGOMA
19535 N 55TH DR
GLENDALE, AZ 85308-6805
Phone number: 614-966-0671
Mailing Address
TOM PLIVATUS ISHENGOMA
3430 BOSTON AVE
OAKLAND, CA 94602-2906
Phone number: 614-966-0671
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