Provider Demographics
NPI:1417149477
Name:MACY CARE II, INC.
Entity Type:Organization
Organization Name:MACY CARE II, INC.
Other - Org Name:DESERT JEWEL AT ABERDEEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:DENEYNE
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-670-4691
Mailing Address - Street 1:28248 N TATUM BLVD
Mailing Address - Street 2:SUITE B1-205
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-6343
Mailing Address - Country:US
Mailing Address - Phone:480-951-0708
Mailing Address - Fax:480-664-9171
Practice Address - Street 1:10639 N ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4849
Practice Address - Country:US
Practice Address - Phone:480-951-0708
Practice Address - Fax:480-659-2573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH 6106310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility