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Organization
LB PHOENIX BETHANY HOME ROAD LLC
Active
Organization
LB PHOENIX BETHANY HOME ROAD LLC
Active
Other names
Chris Ridge Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MICHAEL BAUSCH (GENERAL MANAGER)
(602) 433-6416
Entity
Organization
Contact information
Practice address
6246 N 19TH AVE, PHOENIX, AZ 85015-1511
(602) 433-6416
(602) 433-6458
Mailing address
6246 N 19TH AVE, PHOENIX, AZ 85015-1511
(602) 433-6416
(602) 433-6458
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
035116
AZ
Other
Enumeration date
01/24/2007
Last updated
09/28/2007
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