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Organization
NORTHERN ARIZONA SENIOR LIVING COMMUNITY, L.L.C.
Active
Organization
NORTHERN ARIZONA SENIOR LIVING COMMUNITY, L.L.C.
Active
Other names
THE PEAKS HEALTH & REHABILITATION
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL W BENSON (AUTHORIZED OFFICIAL)
(952) 361-8000
Entity
Organization
Contact information
Practice address
3150 N WINDING BROOK RD, FLAGSTAFF, AZ 86001-0972
(928) 774-7106
(928) 213-0831
Mailing address
1107 HAZELTINE BLVD, SUITE 200, CHASKA, MN 55318-1009
(952) 361-8000
(952) 361-8060
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
ALC-2517
AZ
314000000X
Skilled Nursing Facility
Primary
NCI-2515
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
504698
EVERCARE SELECT
—
05
—
504698
—
AZ
05
—
582230
—
AZ
01
—
AZ0206980
BCBS OF AZ MANAGED CARE
AZ
Enumeration date
06/13/2006
Last updated
02/21/2020
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