Provider Demographics
NPI:1568783116
Name:HOUSE OF CARE & PRAYER LLC
Entity Type:Organization
Organization Name:HOUSE OF CARE & PRAYER LLC
Other - Org Name:HOUSE OF CARE & PRAYER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIONTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-284-0966
Mailing Address - Street 1:2621 N BAHANA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3306
Mailing Address - Country:US
Mailing Address - Phone:520-284-0966
Mailing Address - Fax:520-298-0412
Practice Address - Street 1:2621 N BAHANA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3306
Practice Address - Country:US
Practice Address - Phone:520-284-0966
Practice Address - Fax:520-298-0412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL14976180310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility