Organization
1217 KENWOOD LLC
Active
Parent organization
1217 KENWOOD LLC
Other names
Minnie Lee's Senior Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
1217 KENWOOD LLC
Authorized official
LADONNA EDGINGTON (OWNER/OPERATOR)
(480) 646-2414
Entity
Organization
Contact information
Practice address
1217 E KENWOOD ST, MESA, AZ 85203
(480) 646-2414
Mailing address
1217 E KENWOOD ST, MESA, AZ 85203
(480) 646-2414
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
09/20/2024
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