# ALLEGIANT HEALTHCARE OF PHOENIX LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1619491123
- **Authorized official:** BRENDA CODY (ADMINISTRATOR)
- **Authorized official phone:** (602) 253-4570

## Contact information

- **Practice address:** 1880 E VAN BUREN ST, PHOENIX, AZ 85006-3742
- **Practice address phone:** (602) 253-4570
- **Mailing address:** 1880 E VAN BUREN ST, PHOENIX, AZ 85006-3742
- **Mailing address phone:** (480) 417-7594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |
| 3140N1450X | Pediatric Skilled Nursing Facility | — | NULL | — |

## Other

- **Enumeration date:** 07/27/2017
- **Last updated:** 06/02/2021