# THE HARBOR LIGHTHOUSE CARE HOME II

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689661639
- **Authorized official:** MR. NICOLAE LUCIAN NEGREA (OWNER)
- **Authorized official phone:** (602) 334-1114

## Contact information

- **Practice address:** 4142 W GROVERS AVE, GLENDALE, AZ 85308-2926
- **Practice address phone:** (602) 334-1114
- **Practice address fax:** (623) 773-9464
- **Mailing address:** 4142 W GROVERS AVE, GLENDALE, AZ 85308-2926
- **Mailing address phone:** (602) 334-1114
- **Mailing address fax:** (623) 773-9464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | ALH-5179 | AZ | Yes |

## Other

- **Enumeration date:** 10/04/2005
- **Last updated:** 10/06/2008