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Organization
AZ ADVANCED CARE LLC
Active
Organization
AZ ADVANCED CARE LLC
Active
Other names
West Lane Home
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA T. SIDDIQUI (ADMINISTRATOR)
(602) 332-0780
Entity
Organization
Contact information
Practice address
3137 W LANE AVE, PHOENIX, AZ 85051-6522
(602) 332-0780
(877) 517-2224
Mailing address
3137 W LANE AVE, PHOENIX, AZ 85051-6522
(602) 332-0780
(877) 517-2224
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AL9510H
AZ
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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