Organization
FRIENDSHIP HOUSE-RVCCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE J PULSIPHER (OWNER)
(928) 333-5975
Entity
Organization
Contact information
Practice address
381 E THIRD AVE, EAGAR, AZ 85925
(928) 333-5975
Mailing address
PO BOX 578, EAGAR, AZ 85925-0578
(928) 333-5975
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002639969
—
AZ
Enumeration date
01/08/2007
Last updated
06/27/2008
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