Organization
ELITE ASSISTED LIVING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISA KAPORALIS (MEMBER)
(602) 339-3617
Entity
Organization
Contact information
Practice address
15755 W SHANGRI LA RD, SURPRISE, AZ 85379-4801
(623) 584-5580
(623) 399-6561
Mailing address
15755 W SHANGRI LA RD, SURPRISE, AZ 85379-4801
(623) 584-5580
(623) 399-6561
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099337
—
AZ
Enumeration date
09/18/2018
Last updated
09/18/2018
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