Provider Demographics
NPI:1275049777
Name:DRINKWATER SENIOR LIVING, INC.
Entity Type:Organization
Organization Name:DRINKWATER SENIOR LIVING, INC.
Other - Org Name:VILLA OCOTILLO ASSISTED LIVING AND MEMORY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GURRIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-313-4599
Mailing Address - Street 1:1600 W BROADWAY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1138
Mailing Address - Country:US
Mailing Address - Phone:602-313-4556
Mailing Address - Fax:
Practice Address - Street 1:3327 N CIVIC CENTER PLZ
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6404
Practice Address - Country:US
Practice Address - Phone:480-946-7111
Practice Address - Fax:480-945-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility