Organization
LYNNE'S ASSISTED LIVING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUPRIEN NICOLE (OWNER)
(702) 292-9169
Entity
Organization
Contact information
Practice address
17628 W PERSHING ST, SURPRISE, AZ 85388-5022
(623) 221-1997
Mailing address
17628 W PERSHING ST, SURPRISE, AZ 85388-5022
(623) 221-1997
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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