IMELDA SIONGCO


Address: 1432 N. De Soto St., Chandler, AZ 85224-7850
Phone: 4807554390

IMELDA SIONGCO (NPI# 1215311238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215311238
Entity Type Individual
Full Name IMELDA SIONGCO
Practice Address 1432 N. De Soto St.
Chandler
AZ 85224-7850
Mailing Address 529 N Saguaro St
Chandler
AZ 85224-4283
Practice Telephone 4807554390
Mailing Telephone 4806006818
Enumeration Date 2015-07-20
Last Update Date 2015-07-20
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 311ZA0620X Custodial Care Facility
Specialization: Adult Care Home
AL8867 AZ Nursing & Custodial Care Facilities
N 311ZA0620X Custodial Care Facility
Specialization: Adult Care Home
AL9060 AZ Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ 825596 05
AZ 825613 05

Office Location

Street Address 1432 N. DE SOTO ST.
City CHANDLER
State AZ
Zip Code 85224-7850

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Taxonomy Information

Taxonomy Code 311ZA0620X
Grouping Nursing & Custodial Care Facilities
Classification Custodial Care Facility
Specialization Adult Care Home

Taxonomy Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Notes: [7/1/2003: new]

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Competitor

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City CHANDLER
Zip Code 85224

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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