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Organization
KINGMAN NO 1 LLC
Active
Organization
KINGMAN NO 1 LLC
Active
Other names
Desert Highlands Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFF SHIRRELL (VICE PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
1081 KATHLEEN AVE, KINGMAN, AZ 86401-3918
(928) 753-5580
Mailing address
PO BOX 1210, SIKESTON, MO 63801-1210
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI306
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
633182
—
AZ
Enumeration date
07/07/2006
Last updated
01/03/2017
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