Provider Demographics
NPI:1962047803
Name:WEAVER CARE HOMES LLC
Entity type:Organization
Organization Name:WEAVER CARE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, ALC
Authorized Official - Phone:480-406-5429
Mailing Address - Street 1:919 W BARROW DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2151
Mailing Address - Country:US
Mailing Address - Phone:480-477-4236
Mailing Address - Fax:480-687-2919
Practice Address - Street 1:919 W BARROW DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2151
Practice Address - Country:US
Practice Address - Phone:480-477-4236
Practice Address - Fax:480-687-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility