Penali Manor LLC

NPI #1992295984 in Laveen, Arizona

Provider Information

NPI Number: 1992295984
Entity Type: Organization
Organization Name: Penali Manor LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 15, 2018
Last Updated: May 15, 2018

Practice Location

Address: 8023 S 51ST DR
City: Laveen
State: Arizona
ZIP Code: 85339-2840
Phone: (480) 207-1272

Authorized Official

Name: PEGGY NYALITA
Title: ADMINISTRATOR
Phone: (302) 530-9489

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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