# NORTH MOUNTAIN HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coronado Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376535674
- **Authorized official:** SOON BURNAM (TREASURER)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 11411 N 19TH AVE, PHOENIX, AZ 85029-3642
- **Practice address phone:** (602) 256-7500
- **Practice address fax:** (602) 943-7697
- **Mailing address:** 11411 N 19TH AVE, PHOENIX, AZ 85029-3642
- **Mailing address phone:** (602) 256-7500
- **Mailing address fax:** (602) 943-7697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NCI-2637 | AZ | Yes |

## Other

- **Enumeration date:** 08/22/2005
- **Last updated:** 02/16/2021