Organization
MADERA ASSISTED LIVING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA C HEYWOOD (OWNER-MANAGER)
(480) 663-3652
Entity
Organization
Contact information
Practice address
707 W PALO VERDE ST, GILBERT, AZ 85233-5841
(480) 663-3652
Mailing address
707 W PALO VERDE ST, GILBERT, AZ 85233-5841
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALH-5008
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002639252
EVERCARE PARADIGM ID NO.
AZ
Enumeration date
01/09/2007
Last updated
08/13/2008
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