Organization
VALLEY VISTA CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FIBIA O COMAN (OWNER/MANAGER)
(623) 434-5567
Entity
Organization
Contact information
Practice address
2206 W SPUR DR, PHOENIX, AZ 85085-5752
(623) 434-5567
Mailing address
2206 W SPUR DR, PHOENIX, AZ 85085-5752
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
ALH6406
AZ
Other
Enumeration date
05/02/2009
Last updated
05/02/2009
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