Provider Demographics
NPI:1407135262
Name:SHERRY'S ADULT CARE HOMES,LLC
Entity Type:Organization
Organization Name:SHERRY'S ADULT CARE HOMES,LLC
Other - Org Name:CIRCLE B ADULT CARE HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MGR.
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRILL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-384-4855
Mailing Address - Street 1:418 N. AUSTIN BLVD.
Mailing Address - Street 2:
Mailing Address - City:WILLCOX
Mailing Address - State:AZ
Mailing Address - Zip Code:85643-1617
Mailing Address - Country:US
Mailing Address - Phone:520-384-4855
Mailing Address - Fax:520-384-6121
Practice Address - Street 1:418 N AUSTIN BLVD
Practice Address - Street 2:
Practice Address - City:WILLCOX
Practice Address - State:AZ
Practice Address - Zip Code:85643-1617
Practice Address - Country:US
Practice Address - Phone:520-384-4855
Practice Address - Fax:520-384-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL3345H/AL3346H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility