Individual
DACIANA RUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20506 N 80TH LN, PEORIA, AZ 85382-4422
(480) 980-1711
Mailing address
20506 N 80TH LN, PEORIA, AZ 85382-4422
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10321H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL10321H
LICENSE
AZ
Enumeration date
06/10/2021
Last updated
06/10/2021
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