Organization
THIRD STREET HOME
Active
Organization
THIRD STREET HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMALIA SIMONA BONDAR (MANAGER)
(480) 610-6974
Entity
Organization
Contact information
Practice address
1053 E 3RD ST, MESA, AZ 85203-8001
(480) 610-6974
(480) 610-6974
Mailing address
1053 E 3RD ST, MESA, AZ 85203-8001
(480) 610-6974
(480) 610-6974
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALH-4846
AZ
311ZA0620X
Adult Care Home Facility
ALH-4846
AZ
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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