Organization
ELQ LLC
Active
Parent organization
ELQ LLC
Other names
VINTAGE WEST ASSISTED CARE, Vintage East Assisted Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELQ LLC
Authorized official
ELAINE D HICKMAN BSHA (MANAGER/ ADMINISTRATOR)
(480) 910-1684
Entity
Organization
Contact information
Practice address
4228 E KIOWA ST, PHOENIX, AZ 85044-1906
(480) 910-1684
Mailing address
4228 E KIOWA ST, PHOENIX, AZ 85044-1906
(480) 910-1684
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/16/2023
Last updated
09/27/2023
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