Organization
FANAKA ENTERPRISES LLC
Active
Other names
La Paz Assisted Living, La Paz Assisted Living III
Organization subpart
No
Provider details
NPI number
Authorized official
CATE KIBERA (OWNER)
(520) 301-9021
Entity
Organization
Contact information
Practice address
3925 E 1ST ST, TUCSON, AZ 85711-1001
(520) 771-9971
(520) 771-9971
Mailing address
3925 E 1ST ST, TUCSON, AZ 85711-1001
(520) 771-9971
(520) 771-9971
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008631
—
AZ
Enumeration date
09/07/2020
Last updated
07/07/2022
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