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Organization
FIVE STAR QUALITY CARE-AZ LLC
Active
Organization
FIVE STAR QUALITY CARE-AZ LLC
Active
Parent organization
FIVE STAR QUALITY CARE-AZ LLC
Other names
La Mesa Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR QUALITY CARE-AZ LLC
Authorized official
PAUL HOAGLAND (CFO)
(617) 796-8292
Entity
Organization
Contact information
Practice address
2470 S ARIZONA AVE, YUMA, AZ 85364-8520
(928) 344-8541
(928) 344-0823
Mailing address
2470 S ARIZONA AVE, YUMA, AZ 85364-8520
(928) 344-8541
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI369
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
559841
—
AZ
Enumeration date
05/22/2006
Last updated
07/09/2015
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