# NORTHERN ARIZONA SENIOR LIVING COMMUNITY, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE PEAKS HEALTH & REHABILITATION
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679515449
- **Authorized official:** RANDALL W BENSON (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (952) 361-8000

## Contact information

- **Practice address:** 3150 N WINDING BROOK RD, FLAGSTAFF, AZ 86001-0972
- **Practice address phone:** (928) 774-7106
- **Practice address fax:** (928) 213-0831
- **Mailing address:** 1107 HAZELTINE BLVD, SUITE 200, CHASKA, MN 55318-1009
- **Mailing address phone:** (952) 361-8000
- **Mailing address fax:** (952) 361-8060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | ALC-2517 | AZ | — |
| 314000000X | Skilled Nursing Facility | NCI-2515 | AZ | Yes |

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 02/21/2020

## 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 |