Provider Demographics
NPI:1073929923
Name:SENIOR CARE SPECIALISTS
Entity Type:Organization
Organization Name:SENIOR CARE SPECIALISTS
Other - Org Name:HEARTLAND MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANNUNZIATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-540-4052
Mailing Address - Street 1:43256 N JACKRABBIT RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-9883
Mailing Address - Country:US
Mailing Address - Phone:480-540-4052
Mailing Address - Fax:
Practice Address - Street 1:43256 N JACKRABBIT RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-9883
Practice Address - Country:US
Practice Address - Phone:480-540-4052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL8596H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility