Organization
DPAC HOLDINGS LLC
Active
Other names
Desert Palm Adult Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEAN GONZVAR (MANAGING MEMBER)
(480) 331-8495
Entity
Organization
Contact information
Practice address
1214 E PALMAIRE DR, PHOENIX, AZ 85020-5429
(602) 943-4842
(877) 867-5390
Mailing address
1214 E PALMAIRE AVE, PHOENIX, AZ 85020-5429
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9483H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
476089
—
AZ
Enumeration date
05/13/2016
Last updated
01/31/2019
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