Organization
ALEGRE CARE HOME
Active
Other names
West Pacific Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL PUCTI (OWNER/ADMINISTRATOR)
(602) 281-6512
Entity
Organization
Contact information
Practice address
4232 W WALTANN LN, PHOENIX, AZ 85053-3772
(602) 281-6512
(602) 281-6512
Mailing address
4232 W WALTANN LN, PHOENIX, AZ 85053-3772
(602) 281-6512
(602) 281-6512
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7051H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
411962
AHCCCS PROVIDER ID
AZ
Enumeration date
04/06/2010
Last updated
04/06/2010
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