Arizona Eastern Star Retirement Center
Assisted Living Facility in Phoenix, AZ. Organization (NPI-2).
NPI number1205824653
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1205824653
- Entity type
- Organization (NPI-2)
- Legal business name
- Arizona Eastern Star Retirement Center
- Organization subpart
- No
- Enumeration date
- Oct 10, 2005
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | ALC-4559 | AZ | Yes |
| 314000000X | Skilled Nursing Facility | nci-307 | AZ |
Other names
- Arizona Eastern Star Home (Other Name)
Practice location
4602 N 24th StPhoenix, AZ 85016-5253
Phone 602-833-8344
Mailing address
4602 N 24th StPhoenix, AZ 85016-5253
Fax 602-553-8344
Authorized official
Maria Parham
Administrator
6029549178
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