Organization
STATE OF ARIZONA STATE DEPT OF FINANCE
Active
Other names
Arizona State Veterans' Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ROSS (ADMINISTRATOR)
(602) 248-1591
Entity
Organization
Contact information
Practice address
4141 NORTH S. HERRERA WAY, PHOENIX, AZ 85012
(602) 512-2955
(602) 265-3497
Mailing address
4141 NORTH S. HERRERA WAY, PHOENIX, AZ 85012
(602) 512-2955
(602) 265-3497
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-447
AZ
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344432
—
AZ
Enumeration date
09/29/2006
Last updated
03/10/2017
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