Organization
ADAGIO LUXURY 4 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANCA MICU (OWNER)
(602) 803-9929
Entity
Organization
Contact information
Practice address
1045 E BETHANY HOME RD, PHOENIX, AZ 85014-2229
(602) 803-9929
Mailing address
1045 E BETHANY HOME RD, PHOENIX, AZ 85014-2229
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10804H
AZ
3104A0625X
Assisted Living Facility (Mental Illness)
AL10804H
AZ
385H00000X
Respite Care
AL10804H
AZ
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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