Provider Demographics
NPI:1245021419
Name:CHERRY GARDEN ASSISTED LIVING LLC
Entity type:Organization
Organization Name:CHERRY GARDEN ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KESHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-932-4985
Mailing Address - Street 1:6120 S KIMBERLEE WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6120 S KIMBERLEE WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-4890
Practice Address - Country:US
Practice Address - Phone:480-932-4985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home