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Organization
STATE OF ARIZONA STATE DEPT OF FINANCE
Active
Organization
STATE OF ARIZONA STATE DEPT OF FINANCE
Active
Other names
Arizona State Veterans' Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ROSS (ADMINISTRATOR)
(602) 248-1591
Entity
Organization
Contact information
Practice address
4141 NORTH S. HERRERA WAY, PHOENIX, AZ 85012
(602) 512-2955
(602) 265-3497
Mailing address
4141 NORTH S. HERRERA WAY, PHOENIX, AZ 85012
(602) 512-2955
(602) 265-3497
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-447
AZ
314000000X
Skilled Nursing Facility
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344432
—
AZ
Enumeration date
09/29/2006
Last updated
03/10/2017
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