Organization
EAGLE PASS SENIOR LIVING LLC
Active
Other names
AMARSI ASSISTED LIVING
Organization subpart
No
Provider details
NPI number
Authorized official
LEE JOHNSON (TREASURER)
(208) 401-1369
Entity
Organization
Contact information
Practice address
5125 N 58TH AVE, GLENDALE, AZ 85301-7453
(623) 915-5720
(623) 931-8776
Mailing address
5125 N 58TH AVE, GLENDALE, AZ 85301-7453
(623) 915-5720
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
01/23/2020
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