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Organization

APOLLO RAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JORDAN GLENN DO (OWNER)
(801) 310-3031
Entity
Organization

Contact information

Practice address
4719 W HARMONT DR, GLENDALE, AZ 85302-6416
(623) 930-6764
(623) 930-1233
Mailing address
8405 W DALEY LN, PEORIA, AZ 85383-2013
(801) 310-3031

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9918H
AZ

Other

Enumeration date
11/01/2017
Last updated
11/01/2017
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