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Organization
COPPER HEALTH ORO VALLEY LLC
Active
Organization
COPPER HEALTH ORO VALLEY LLC
Active
Other names
Copper Health Oro Valley
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY TERRENCE MCNELLIS (OWNER/MANAGER)
(612) 991-9062
Entity
Organization
Contact information
Practice address
1119 E RANCHO VISTOSO BLVD, ORO VALLEY, AZ 85755-9106
(520) 823-4669
Mailing address
3602 E GREENWAY RD, SUITE 104, PHOENIX, AZ 85032-4648
(602) 368-8203
(602) 368-8211
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI2725
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCI2725
ARIZONA DEPT. OF HEALTH SERVICES
AZ
Enumeration date
01/08/2014
Last updated
07/07/2015
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