Organization
DESERT GEM ASSISTED LIVING FACILITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIOSCORO ANGELO TAGLE JR. (OWNER/MANAGER)
(480) 208-5137
Entity
Organization
Contact information
Practice address
3236 W. EUGIE AVENUE, PHOENIX, AZ 85029
(480) 639-3290
(480) 639-5748
Mailing address
1734 E. BAHREND DRIVE, PHOENIX, AZ 85024-1205
(480) 208-5137
(480) 369-5748
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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