Provider Demographics
NPI:1245729995
Name:LORNA ENTERPRISES,LLC
Entity type:Organization
Organization Name:LORNA ENTERPRISES,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CONOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-693-0839
Mailing Address - Street 1:15612 W SHANGRI LA RD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-4795
Mailing Address - Country:US
Mailing Address - Phone:623-693-0839
Mailing Address - Fax:623-234-8655
Practice Address - Street 1:15550 W CAMERON DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-1055
Practice Address - Country:US
Practice Address - Phone:623-693-0839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL7402H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ405898Medicaid