Provider Demographics
NPI:1568641751
Name:ARBOR ROSE SENIOR CARE LLC
Entity type:Organization
Organization Name:ARBOR ROSE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.N. / EXECUTIVE DIRECTOR, MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SWAIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-628-8550
Mailing Address - Street 1:6033 E ARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-6100
Mailing Address - Country:US
Mailing Address - Phone:480-654-8200
Mailing Address - Fax:480-981-9379
Practice Address - Street 1:6033 E ARBOR AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-6100
Practice Address - Country:US
Practice Address - Phone:480-654-8200
Practice Address - Fax:480-981-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZADHC-5191385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care