Provider Demographics
NPI:1770121337
Name:A PLACE LIKE HOME INC
Entity type:Organization
Organization Name:A PLACE LIKE HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO EXCUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNTINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCLAURIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-500-8462
Mailing Address - Street 1:45646 W LONG WAY
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-7070
Mailing Address - Country:US
Mailing Address - Phone:480-500-8462
Mailing Address - Fax:480-470-3630
Practice Address - Street 1:45646 W LONG WAY
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-7070
Practice Address - Country:US
Practice Address - Phone:773-710-8829
Practice Address - Fax:480-470-3630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals