Provider Demographics
NPI:1861949612
Name:RENATA'S HOME FOR THE ELDERLY # 2 INC
Entity type:Organization
Organization Name:RENATA'S HOME FOR THE ELDERLY # 2 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEDROWSKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1480-304-2922
Mailing Address - Street 1:31392 N SUNFLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-4330
Mailing Address - Country:US
Mailing Address - Phone:148-030-4292
Mailing Address - Fax:148-027-5832
Practice Address - Street 1:31392 N SUNFLOWER WAY
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-4330
Practice Address - Country:US
Practice Address - Phone:148-030-4292
Practice Address - Fax:148-027-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL8420H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility