Provider Demographics
NPI:1063871945
Name:PAPY MCGUIRE ASSISTED LIVING HOME LLC
Entity type:Organization
Organization Name:PAPY MCGUIRE ASSISTED LIVING HOME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:APODACA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-887-5402
Mailing Address - Street 1:202 W FORT LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705
Mailing Address - Country:US
Mailing Address - Phone:520-887-5402
Mailing Address - Fax:520-887-0182
Practice Address - Street 1:202 W FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3814
Practice Address - Country:US
Practice Address - Phone:520-887-5402
Practice Address - Fax:520-887-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9941L310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAL9941HOtherAL9941H