Provider Demographics
NPI:1619488459
Name:FRIENDSHIP RETIREMENT ORGANIZATION
Entity Type:Organization
Organization Name:FRIENDSHIP RETIREMENT ORGANIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:623-847-3006
Mailing Address - Street 1:8611 N 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4351
Mailing Address - Country:US
Mailing Address - Phone:623-847-3006
Mailing Address - Fax:
Practice Address - Street 1:8611 N 67TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4351
Practice Address - Country:US
Practice Address - Phone:623-847-3006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility