Provider Demographics
NPI:1699153270
Name:HOPI ASSISTED LIVING FACILITY INC.
Entity type:Organization
Organization Name:HOPI ASSISTED LIVING FACILITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOYOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-283-8780
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:HOPI ASSISTED LIVING
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-0397
Mailing Address - Country:US
Mailing Address - Phone:928-283-8780
Mailing Address - Fax:
Practice Address - Street 1:21 SENIOR LANE UPPER HUD HOUSING MOENKOPI
Practice Address - Street 2:HOPI ASSISTED LIVING
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045
Practice Address - Country:US
Practice Address - Phone:928-283-8780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9305C305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service