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Organization
THE HARBOR LIGHHOUSE II
Active
Organization
THE HARBOR LIGHHOUSE II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COSTEL TIRDEA (OWNER)
(602) 358-8604
Entity
Organization
Contact information
Practice address
4142 W GROVERS AVE, GLENDALE, AZ 85308-2926
(602) 358-8604
(602) 606-2356
Mailing address
4142 W GROVERS AVE, GLENDALE, AZ 85308-2926
(602) 358-8604
(602) 606-2356
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALH-6343
AZ
Other
Enumeration date
11/26/2009
Last updated
11/26/2009
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