Organization
LABELLA ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENID BALLENTINE (MANAGER)
(928) 757-2736
Entity
Organization
Contact information
Practice address
1721 PALO VERDE DR, KINGMAN, AZ 86409-3091
(928) 757-2736
(928) 565-7472
Mailing address
1721 PALO VERDE DR, KINGMAN, AZ 86409-3091
(928) 757-2736
(928) 565-7472
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALH5972
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204863
—
AZ
Enumeration date
05/31/2007
Last updated
06/19/2008
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