MRS. MELVA LYNETTE WILSON-CALVIN RN
Adult Care Home
Gilbert, Arizona
Provider NPI: 1780743195
Provider Information:MRS. MELVA LYNETTE WILSON-CALVIN RN
Practice Location:
22831 S RECKER RD GILBERT, AZ 85297 US
Tel: 480-279-1071 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | AZ | AFC-5336 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
AHCCCS ID | 482448 | AZ | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin