NPI 1114262292

Boulder Gardens Assistant Living, LLC

Organisation Assisted Living Facility Prescott, AZ

Practice location

Address: 860 Dougherty St, Prescott, AZ 86305-1841
Phone: (928) 778-9667
Fax: (520) 393-1044
Mailing address: 150 N La Canada Dr, Green Valley, AZ 85614-3129

Authorised official

Name: Carl Zimmerman
Title: Senior Vice President
Phone: (520) 352-3019

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence AL1494C (AZ)

Other Assisted Living Facility providers in Arizona →

Registry record

NPI: 1114262292
Entity type: Organization
NPI issued: 30 Nov 2012
Record last updated: 30 Nov 2012

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.