Organization
LOS NINO'S DAY CARE OF CATALINA LLC
Active
Other names
Mary & Pete's Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA ANN GONZALES (OWNER)
(520) 400-4217
Entity
Organization
Contact information
Practice address
203 E AVENUE I, SAN MANUEL, AZ 85631-1357
(520) 909-3241
Mailing address
PO BOX 74, SAN MANUEL, AZ 85631-0074
(520) 909-3241
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9394H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004189
AHCCCS
AZ
Enumeration date
05/15/2016
Last updated
05/15/2016
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