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John Henry Martin Lico
Assisted Living Facility in Surprise, Arizona
NPI 1003432667

John Henry Martin Lico is an Assisted Living Facility based in Surprise, AZ. John Henry Martin Lico practices in Surprise, AZ. The NPI Number for John Henry Martin Lico is 1003432667 and holds a License No. AL11496H (Arizona).

The current practice location address for John Henry Martin Lico is 15244 W Watson Ln, Surprise, AZ and can be reached out via phone at 623-227-9697.

Location: 15244 W Watson Ln, Surprise, AZ, 85379-7040
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003432667
Provider Name
John Henry Martin Lico
Credential
Provider Entity Type
Individual
Gender
Male
Address
15244 W Watson Ln, Surprise, AZ, 85379-7040
Phone Number
623-227-9697
Fax Number
Provider Enumeration Date
06/19/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
15244 W Watson Ln
City
Surprise
State
Arizona
Zip
85379-7040
Phone Number
623-227-9697
Fax Number
person
Provider Business Mailing Address Details
Address
15244 W Watson Ln
City
Surprise
State
Arizona
Zip
85379-7040
Phone Number
623-227-9697
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
AL11496H (Arizona)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
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