Organization
HOLLYHOCK ASSISTED LIVING LLC
Active
Other names
Hollyhock Assisted Living LLC
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA SIDDIQUI (ADMINISTRATOR)
(602) 332-0780
Entity
Organization
Contact information
Practice address
16552 N HOLLYHOCK ST, SURPRISE, AZ 85378-3667
(160) 233-2078
Mailing address
16552 N HOLLYHOCK ST, SURPRISE, AZ 85378-3667
(160) 233-2078
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
AZ
Enumeration date
01/25/2022
Last updated
01/25/2022
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