Organization
ELITE ASSISTED LIVING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA WOODWORTH (OWNER)
(602) 743-9924
Entity
Organization
Contact information
Practice address
15928 W IRONWOOD DR, WADDELL, AZ 85355-2001
(602) 743-9924
Mailing address
9559 W PINNACLE VISTA DR, PEORIA, AZ 85383-8715
(602) 743-9924
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8356H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498514
—
AZ
Enumeration date
12/13/2016
Last updated
12/13/2016
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