Provider Demographics
NPI:1417567371
Name:ZAWEAH LUXURY LIVING LLC
Entity Type:Organization
Organization Name:ZAWEAH LUXURY LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-869-0658
Mailing Address - Street 1:9129 S 48TH DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2242
Mailing Address - Country:US
Mailing Address - Phone:860-869-0658
Mailing Address - Fax:
Practice Address - Street 1:9129 S 48TH DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-2242
Practice Address - Country:US
Practice Address - Phone:860-869-0658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home