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Organization
SLO RIDGECREST LLC
Active
Organization
SLO RIDGECREST LLC
Active
Other names
RidgeCrest Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COLLEEN HELEN SWEET (MANAGING MEMBER)
(480) 797-9948
Entity
Organization
Contact information
Practice address
16640 N 38TH ST, PHOENIX, AZ 85032-2103
(602) 482-6671
(602) 482-3541
Mailing address
16640 N 38TH ST, PHOENIX, AZ 85032-2103
(602) 482-6671
(602) 482-3541
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NCI2651
AZ
314000000X
Skilled Nursing Facility
Primary
NCI2651
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
924771
—
AZ
Enumeration date
10/10/2005
Last updated
02/12/2013
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