Provider Demographics
NPI:1003664640
Name:A LOVING HEART ASSISTED LIVING II
Entity type:Organization
Organization Name:A LOVING HEART ASSISTED LIVING II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOJEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-334-2343
Mailing Address - Street 1:PO BOX 6288
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85261-6288
Mailing Address - Country:US
Mailing Address - Phone:571-334-2343
Mailing Address - Fax:
Practice Address - Street 1:17450 W WOOD DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-5104
Practice Address - Country:US
Practice Address - Phone:571-334-2343
Practice Address - Fax:480-718-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility