Organization
MARY ELAINE COOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACKSON WEAVER (RECURTOR)
(480) 345-6668
Entity
Organization
Contact information
Practice address
2145 SANTA CATALINA DR, SIERRA VISTA, AZ 85635-3321
(520) 458-1736
Mailing address
2145 SANTA CATALINA DR, SIERRA VISTA, AZ 85635-3321
(520) 458-1736
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
RN138025
AZ
251J00000X
Nursing Care Agency
Primary
RN9218626
FL
Other
Enumeration date
11/02/2009
Last updated
11/02/2009
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