Provider Demographics
NPI:1023302627
Name:PHILIPPINE FAMILY CARE HOMES LLC
Entity type:Organization
Organization Name:PHILIPPINE FAMILY CARE HOMES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIMBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:480-205-1663
Mailing Address - Street 1:18567 E OLD BEAU TRL
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3516
Mailing Address - Country:US
Mailing Address - Phone:480-205-1663
Mailing Address - Fax:
Practice Address - Street 1:1256 E ELM RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-3200
Practice Address - Country:US
Practice Address - Phone:480-677-3471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH5502310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility