Organization
SENIOR LIVING OPTIONS MARYLAND GARDENS, LLC
Active
Other names
Maryland Gardens Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN MOCKBEE (ADMINISTRATOR)
(602) 265-7484
Entity
Organization
Contact information
Practice address
31 W MARYLAND AVE, PHOENIX, AZ 85013-1227
(602) 265-7484
(602) 265-0659
Mailing address
31 W MARYLAND AVE, PHOENIX, AZ 85013-1227
(602) 265-7484
(602) 265-0659
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-046
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
234731
—
AZ
Enumeration date
10/05/2006
Last updated
06/17/2008
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