Organization
RENAISSANCE VILLAGE AL, LLC D/B/A SPRINGDALE VILLAGE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA L CARLSON (PRESIDENT OF OPERATIONS)
(480) 981-8844
Entity
Organization
Contact information
Practice address
7255 E BROADWAY RD, MESA, AZ 85208-9201
(480) 981-8844
(480) 981-6998
Mailing address
7255 E BROADWAY RD, MESA, AZ 85208-9201
(480) 981-8844
(480) 981-6998
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALC6843
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
392683
—
AZ
Enumeration date
01/21/2009
Last updated
01/21/2009
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