| Pastalino Manor Llc 2 | |
|
1383 W Kesler Ln Chandler AZ 85224-7289 | |
| (480) 634-5485 | |
| (480) 699-7288 |
| Full Name | Pastalino Manor Llc 2 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1383 W Kesler Ln, Chandler, Arizona |
| Authorized Official Name and Position | Paul Munyao Kivila (ADMINISTRATOR) |
| Authorized Official Contact | 4806345485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pastalino Manor Llc 2 1393 W Kesler Ln Chandler AZ 85224-7229 Ph: (480) 634-5485 | Pastalino Manor Llc 2 1383 W Kesler Ln Chandler AZ 85224-7289 Ph: (480) 634-5485 |
| NPI Number | 1326432741 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 03/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326432741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH 4431 (Arizona) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH 4431 (Arizona) | Secondary |
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