Organization
RICHMOND MANOR ADULT CARE
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA VIRGINIA NIEVERA CORDOVA (MANAGER-OWNER)
(480) 703-7396
Entity
Organization
Contact information
Practice address
4356 W ST CATHERINE AVE, LAVEEN, AZ 85339-6233
(480) 703-7396
(602) 237-0829
Mailing address
4356 W ST CATHERINE AVE, LAVEEN, AZ 85339-6233
(480) 703-7396
(602) 237-0829
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALH5949
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162266
AHCCS
AZ
Enumeration date
06/15/2007
Last updated
08/22/2020
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