Organization
GLENDALE HEALTHCARE ASSOC., LLC
Active
Parent organization
GLENDALE HEALTHCARE ASSOCIATES, LLC
Other names
Desert Sky Health and Rehabilitation
Organization subpart
Yes
Provider details
NPI number
Legal business name
GLENDALE HEALTHCARE ASSOCIATES, LLC
Authorized official
TIM RITER COTA (DIRECTOR OF REHAB)
(623) 931-5800
Entity
Organization
Contact information
Practice address
5125 N 58TH AVE, GLENDALE, AZ 85301-7453
(623) 931-5800
(623) 931-8776
Mailing address
5125 N 58TH AVE, GLENDALE, AZ 85301-7453
(623) 931-5800
(623) 931-8776
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OTC 3638
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035092
MEDICARE
AZ
05
—
688070
—
AZ
Enumeration date
10/15/2009
Last updated
10/15/2009
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