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Organization

ST. JOSEPH ASSISTED LIVING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHIELA E PHILLIPS (OWNER/ CAREGIVER)
(623) 692-0413
Entity
Organization

Contact information

Practice address
1338 E TONTO LN, PHOENIX, AZ 85024-1772
(623) 692-0413
(623) 440-8112
Mailing address
1338 E TONTO LN, PHOENIX, AZ 85024-1772
(623) 692-0413
(623) 440-8112

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
492956
PROVIDER ACCESS NUMBER
AZ
Enumeration date
05/24/2019
Last updated
06/11/2019
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