Organization
15810 SOUTH 42ND STREET OPERATIONS LLC
Active
Other names
La Estancia Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BERG (ASSISTANT SECRETARY)
(610) 925-2254
Entity
Organization
Contact information
Practice address
15810 S 42ND ST, PHOENIX, AZ 85048-7409
(480) 759-0358
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-2254
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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