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Organization
ST. MICHAEL'S MANOR
Active
Organization
ST. MICHAEL'S MANOR
Active
Other names
TERESITA And MARIO CABACUNGAN
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESITA ARCENA CABACUNGAN (OWNER)
(562) 673-3214
Entity
Organization
Contact information
Practice address
8449 W SHAW BUTTE DR, PEORIA, AZ 85345-8160
(623) 486-5987
(623) 328-5530
Mailing address
8449 W SHAW BUTTE DR, PEORIA, AZ 85345-8160
(623) 486-5987
(623) 328-5530
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALH-4384
AZ
311ZA0620X
Adult Care Home Facility
ALH-5308
AZ
311ZA0620X
Adult Care Home Facility
ALH6365
AZ
Other
Enumeration date
11/09/2006
Last updated
05/31/2008
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