Organization
EDELWEISS ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAN MOHAN SUGATHAN (OWNER)
(602) 456-0041
Entity
Organization
Contact information
Practice address
19918 N 65TH AVE, GLENDALE, AZ 85308-7088
(602) 456-0041
Mailing address
19918 N 65TH AVE, GLENDALE, AZ 85308-7088
(602) 456-0041
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/01/2018
Last updated
12/01/2018
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