Organization
PARKSIDE VILLA ASSISTED LIVING LLC
Active
Organization
PARKSIDE VILLA ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLORIDA BOMONGCAG (OWNER/MEMBER)
(480) 292-7387
Entity
Organization
Contact information
Practice address
1502 N ROCHESTER DR, GILBERT, AZ 85234-1472
(480) 292-7387
Mailing address
1502 N ROCHESTER DR, GILBERT, AZ 85234-1472
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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