NPI 1235865254

Ponderosa Pine Healthcare, INC.

Organisation Skilled Nursing Facility Mesa, AZ

Practice location

Address: 3130 E Broadway Rd, Mesa, AZ 85204-1740
Phone: (480) 924-7777
Fax: (480) 924-5712

Authorised official

Name: Soon Burnam
Title: Treasurer
Phone: (949) 540-1249

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X

Other Skilled Nursing Facility providers in Arizona →

Registry record

NPI: 1235865254
Entity type: Organization
NPI issued: 1 Aug 2022
Record last updated: 1 Aug 2022

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.