Provider First Line Business Practice Location Address:
3040 N 36TH ST
Provider Second Line Business Practice Location Address:
KIVEL MANOR ASSISTED LIVING
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-443-8020
Provider Business Practice Location Address Fax Number:
602-957-9493
Provider Enumeration Date:
07/27/2006