# PRESCOTT NURSING AND REHABILITATION CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407191588
- **Authorized official:** CARL ZIMMERMAN (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (520) 352-3019

## Contact information

- **Practice address:** 864 DOUGHERTY ST, PRESCOTT, AZ 86305-1841
- **Practice address phone:** (928) 778-9667
- **Practice address fax:** (520) 393-1044
- **Mailing address:** 150 N LA CANADA DR, GREEN VALLEY, AZ 85614-3129
- **Mailing address phone:** (520) 352-3018
- **Mailing address fax:** (520) 393-1044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NCI-379 | AZ | Yes |

## Other

- **Enumeration date:** 11/30/2012
- **Last updated:** 01/28/2013