Provider Demographics
NPI:1417580747
Name:METROPOLITAN ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:METROPOLITAN ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:BIKERI
Authorized Official - Last Name:OGOTI
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:469-671-4136
Mailing Address - Street 1:642 E KENT AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1769
Mailing Address - Country:US
Mailing Address - Phone:480-265-9133
Mailing Address - Fax:480-265-9133
Practice Address - Street 1:642 E KENT AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1769
Practice Address - Country:US
Practice Address - Phone:480-265-9133
Practice Address - Fax:480-265-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility