person
Tom Plivatus Ishengoma
Assisted Living Facility in Glendale, Arizona
NPI 1558135574

Tom Plivatus Ishengoma is an Assisted Living Facility based in Oakland, AZ. Tom Plivatus Ishengoma practices in Glendale, AZ. The NPI Number for Tom Plivatus Ishengoma is 1558135574 and holds a License No. (Arizona).

The current practice location address for Tom Plivatus Ishengoma is 19535 N 55Th Dr, Glendale, AZ and can be reached out via phone at 614-966-0671.

Location: 19535 N 55Th Dr, Glendale, AZ, 94602-2906
person
Provider Profile Details
NPI Number
1558135574
Provider Name
Tom Plivatus Ishengoma
Credential
Provider Entity Type
Individual
Gender
Male
Address
19535 N 55Th Dr, Glendale, AZ, 94602-2906
Phone Number
614-966-0671
Fax Number
Provider Enumeration Date
11/09/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
19535 N 55Th Dr
City
State
Zip
85308-6805
Phone Number
614-966-0671
Fax Number
person
Provider Business Mailing Address Details
Address
19535 N 55Th Dr
City
State
Zip
85308-6805
Phone Number
614-966-0671
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
License No.
()
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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