Organization
1203 PALLOVERDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN HACKETT (PRESIDENT)
(202) 288-0422
Entity
Organization
Contact information
Practice address
1203 W PALO VERDE DR, CHANDLER, AZ 85224-2358
(202) 288-0422
Mailing address
1203 W PALO VERDE DR, CHANDLER, AZ 85224-2358
(202) 288-0422
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
AL7815H
AZ
Other
Enumeration date
08/28/2010
Last updated
08/28/2010
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