Provider Demographics
NPI:1922326693
Name:MEMORY CARE OF ARIZONA
Entity Type:Organization
Organization Name:MEMORY CARE OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CORA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-402-8171
Mailing Address - Street 1:21061 E STIRRUP ST
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6523
Mailing Address - Country:US
Mailing Address - Phone:480-730-8502
Mailing Address - Fax:
Practice Address - Street 1:21061 E STIRRUP ST
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6523
Practice Address - Country:US
Practice Address - Phone:480-730-8502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEGGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty