# THE BEATITUDES CAMPUS

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

## Provider details

- **NPI number:** 1508856089
- **Authorized official:** MS. CAMMY CLEVENGER (CONTROLLER)
- **Authorized official phone:** (602) 995-2611

## Contact information

- **Practice address:** 1616 W GLENDALE AVE, PHOENIX, AZ 85021-8948
- **Practice address phone:** (602) 995-2611
- **Practice address fax:** (602) 995-6127
- **Mailing address:** 1616 W GLENDALE AVE, PHOENIX, AZ 85021-8948
- **Mailing address phone:** (602) 995-2611
- **Mailing address fax:** (602) 995-6127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | ALC-4281 | AZ | — |
| 314000000X | Skilled Nursing Facility | NCI-256 | AZ | Yes |

## Other

- **Enumeration date:** 10/25/2005
- **Last updated:** 11/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 040163 | — | AZ |