NPI 1013009745

State of Arizona State Dept of Finance

Organisation Skilled Nursing Facility Phoenix, AZ

Practice location

Address: 4141 North S. Herrera Way, Phoenix, AZ 85012
Phone: (602) 512-2955
Fax: (602) 265-3497

Authorised official

Name: James Ross
Title: Administrator
Phone: (602) 248-1591

Registered specialties (2)

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence NCI-447 (AZ)

Other Skilled Nursing Facility providers in Arizona →

Skilled Nursing Facility

Nursing & Custodial Care Facilities Taxonomy 314000000X

Registry record

NPI: 1013009745
Entity type: Organization
NPI issued: 29 Sep 2006
Record last updated: 10 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.