Individual provider · NPI-1

Josephine Jimenez

Custodial Care Facility, Adult Care Home · Tempe, AZ

NPI number1952764102
StatusActive
Last updated in NPPESApr 19, 2023

Details

NPI
1952764102
Entity type
Individual (NPI-1)
Name
Josephine Jimenez
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 4, 2016
Certification date
Apr 19, 2023
Last updated
Apr 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
311ZA0620X Custodial Care Facility, Adult Care HomeAL9899HAZYes
310400000X Assisted Living FacilityAL10146HAZ

Practice location

804 W Orion St
Tempe, AZ 85283-2735

Phone 480-295-5640

Mailing address

804 W Orion St
Tempe, AZ 85283-2735

Phone 480-240-0278 · Fax 480-838-9668

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