Provider Demographics
NPI:1831781947
Name:C&D ASSISTED LIVING HOMES LLC
Entity type:Organization
Organization Name:C&D ASSISTED LIVING HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMWEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MWANGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-585-3398
Mailing Address - Street 1:38103 N BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-4158
Mailing Address - Country:US
Mailing Address - Phone:314-585-3398
Mailing Address - Fax:
Practice Address - Street 1:17652 N AVELINO DR
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-4979
Practice Address - Country:US
Practice Address - Phone:520-472-2376
Practice Address - Fax:520-472-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care