Organization
HALLMARK ASSISTED LIVING @ WAGONER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF TILLEY (MANAGER)
(602) 695-4156
Entity
Organization
Contact information
Practice address
6127 W WAGONER RD, GLENDALE, AZ 85308-1150
(602) 354-8941
Mailing address
4365 E PECOS RD STE 133, GILBERT, AZ 85295-8053
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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