Provider Demographics
NPI:1770026635
Name:SDANCEL MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:SDANCEL MANAGEMENT SERVICES, LLC
Other - Org Name:GOLDEN CARE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTOS
Authorized Official - Middle Name:CAINTIC
Authorized Official - Last Name:DANCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-755-5359
Mailing Address - Street 1:15724 N 168TH LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-1349
Mailing Address - Country:US
Mailing Address - Phone:623-755-5359
Mailing Address - Fax:623-322-1968
Practice Address - Street 1:15724 N 168TH LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-1349
Practice Address - Country:US
Practice Address - Phone:623-755-5359
Practice Address - Fax:623-322-1968
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA COMFORT CARE-SURPRISE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9154H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ141476Medicaid