Organization
PROGRESS AZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWITAR RUMICHO (OWNER)
(602) 930-8424
Entity
Organization
Contact information
Practice address
7113 W SOPHIE LN, LAVEEN, AZ 85339-3475
(602) 930-8424
Mailing address
7846 W TUCKEY LN, GLENDALE, AZ 85303-3413
(602) 930-8424
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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