Organization
DESERT EMERALD ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL BOMONGCAG (OWNER)
(650) 580-7035
Entity
Organization
Contact information
Practice address
4526 N 82ND ST, SCOTTSDALE, AZ 85251-1702
(480) 203-2263
(480) 773-7279
Mailing address
4526 N 82ND ST, SCOTTSDALE, AZ 85251-1702
(480) 203-2263
(480) 773-7279
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL6530H
AZ
Other
Enumeration date
07/11/2011
Last updated
07/11/2011
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