# ILHC OF PHOENIX, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ARIZONA GRAND SENIOR LIVING COMMUNITY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902983265
- **Authorized official:** ELAINE R. BURTON (PRESIDENT & CHAIR OF BD OF MANAGERS)
- **Authorized official phone:** (952) 361-8000

## Contact information

- **Practice address:** 4602 N 24TH ST, PHOENIX, AZ 85016-5253
- **Practice address phone:** (602) 954-9178
- **Practice address fax:** (602) 553-8344
- **Mailing address:** 1107 HAZELTINE BLVD, SUITE 200, CHASKA, MN 55318-1009
- **Mailing address phone:** (952) 361-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | ALC-5695 | AZ | — |
| 314000000X | Skilled Nursing Facility | NCI-2656 | AZ | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 12/08/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | AZ0914230 | BCBS OF ARIZONA | — |