# SUN VALLEY LODGE

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

## Provider details

- **NPI number:** 1518263052
- **Authorized official:** MR. MICHAEL FAHEY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (623) 933-0137

## Contact information

- **Practice address:** 12415 N 103RD AVE, SUN CITY, AZ 85351-3509
- **Practice address phone:** (623) 933-0137
- **Mailing address:** 12415 N 103RD AVE, SUN CITY, AZ 85351-3509
- **Mailing address phone:** (623) 933-0137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NCI-258 | AZ | Yes |

## Other

- **Enumeration date:** 02/01/2011
- **Last updated:** 02/01/2011