Organization
NEL'S NEST ASSISTED LIVING , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARON WHITE (OWNER/ ADMINISTRATOR)
(602) 882-2766
Entity
Organization
Contact information
Practice address
3655 W DYNAMITE BLVD, PHOENIX, AZ 85083-0860
(602) 882-2766
(623) 321-9960
Mailing address
3655 W DYNAMITE BLVD, PHOENIX, AZ 85083-0860
(602) 882-2766
(623) 321-9960
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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