Organization
EVMARK CORP
Active
Other names
Extended Family Assisted Living Homes
Organization subpart
No
Provider details
NPI number
Authorized official
MARTA C LOGAN (EXECUTIVE DIRECTOR)
(480) 833-6328
Entity
Organization
Contact information
Practice address
2556 E HERMOSA VISTA DR, MESA, AZ 85213-2304
(480) 833-6328
Mailing address
1942 N CALLE MADERAS, MESA, AZ 85213-2908
(480) 833-6328
(480) 827-9178
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
AL4343H
AZ
310400000X
Assisted Living Facility
Primary
ALH-1203
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219747
—
AZ
05
—
219819
—
AZ
Enumeration date
03/27/2013
Last updated
03/27/2013
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