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Organization
LDRKAIR
Active
Organization
LDRKAIR
Active
Other names
The Carriage House on West Garden Lane
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY DOUGLAS MATYAS (OWNER)
(928) 536-7935
Entity
Organization
Contact information
Practice address
395 W GARDEN LN, SNOWFLAKE, AZ 85937-6218
(928) 536-7935
(928) 536-5444
Mailing address
395 W GARDEN LN, SNOWFLAKE, AZ 85937-6218
(928) 536-7935
(928) 536-5444
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALC-4533
AZ
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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