Organization
ST WALTER GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WELYN MORMINO (ADMINISTRATOR)
(805) 878-9914
Entity
Organization
Contact information
Practice address
8650 S LOS FELIZ DR, TEMPE, AZ 85284-2583
(805) 878-9914
Mailing address
8650 S LOS FELIZ DR, TEMPE, AZ 85284-2583
(805) 878-9914
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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