Organization
ELDERCARE FOR LIFE
Active
Other names
Thoroughcare Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA VANDIVORT (PRESIDENT)
(520) 803-1234
Entity
Organization
Contact information
Practice address
6164 S HIGHWAY 92, HEREFORD, AZ 85615-9283
(520) 803-1234
(520) 803-6552
Mailing address
PO BOX 429, HEREFORD, AZ 85615-0429
(520) 803-1234
(520) 803-6552
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2008
Last updated
12/16/2011
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