Provider Demographics
NPI:1497234710
Name:MAGLALANG, SAMPAGUITA D
Entity Type:Individual
Prefix:
First Name:SAMPAGUITA
Middle Name:D
Last Name:MAGLALANG
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SAMPAGUITA
Other - Middle Name:D
Other - Last Name:MAGLALANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:MY HOME CARE ADULT ASSISTED LIVING FACILITY, LLC.
Mailing Address - Street 2:2607 WEST CURRY STREET
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1040
Mailing Address - Country:US
Mailing Address - Phone:480-330-6850
Mailing Address - Fax:480-897-6043
Practice Address - Street 1:MY HOME CARE ADULT ASSISTED LIVING FACILITY, LLC.
Practice Address - Street 2:2607 WEST CURRY STREET
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1040
Practice Address - Country:US
Practice Address - Phone:480-330-6850
Practice Address - Fax:480-897-6043
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL8230H320700000X
AZAL10338H320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAL10338HOtherCARE HOME FOR ADULTS
AZAL8230HOtherPRECIOUS LOVE ADULT ASSISTED LIVING FACILITY,LLC.