| Pastalino Manor Llc | |
|
4929 E Laurel Ln Scottsdale AZ 85254-4640 | |
| (951) 236-4717 | |
| (480) 664-7668 |
| Full Name | Pastalino Manor Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4929 E Laurel Ln, Scottsdale, Arizona |
| Authorized Official Name and Position | Paul Munyao Kivila (CEO) |
| Authorized Official Contact | 4806345485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pastalino Manor Llc 1383 W Kesler Ln Chandler AZ 85224-7289 Ph: (951) 236-4717 | Pastalino Manor Llc 4929 E Laurel Ln Scottsdale AZ 85254-4640 Ph: (951) 236-4717 |
| NPI Number | 1922678416 |
|---|---|
| Provider Enumeration Date | 06/28/2021 |
| Last Update Date | 06/28/2021 |
| Certification Date | 06/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922678416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Secondary |
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