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Individual

MARIA DEL CARMEN LEON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11320 W TERATAI ST, STAR, ID 83669-6363
(928) 798-0191
Mailing address
11320 W TERATAI ST, STAR, ID 83669-6363
(928) 798-0191

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
CFH-10217
ID

Other

Enumeration date
12/03/2024
Last updated
12/03/2024
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