Organization
MARTHA ANNS RAINBOW HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG PHILLIP GITTENS (OWNER)
(480) 968-6008
Entity
Organization
Contact information
Practice address
2638 S HOLBROOK LN, TEMPE, AZ 85282-2940
(480) 968-6008
(480) 902-1291
Mailing address
2638 S HOLBROOK LN, TEMPE, AZ 85282-2940
(480) 968-6008
(480) 902-1291
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
497086
AHCCCS
AZ
Enumeration date
06/19/2019
Last updated
06/19/2019
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