Provider Demographics
NPI:1194448837
Name:THE GREENWAY MANOR ASSISTED LIVING LLC
Entity type:Organization
Organization Name:THE GREENWAY MANOR ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUJDEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-703-3230
Mailing Address - Street 1:5235 E WAGONER RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-7635
Mailing Address - Country:US
Mailing Address - Phone:480-703-3230
Mailing Address - Fax:602-404-7504
Practice Address - Street 1:5235 E WAGONER RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-7635
Practice Address - Country:US
Practice Address - Phone:480-703-3230
Practice Address - Fax:602-404-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility