Organization
LSREF GOLDEN OPS UE (AZ), LLC
Active
Other names
Inn at the Amethyst Assisted Living and Memory Care
Organization subpart
No
Provider details
NPI number
Authorized official
WICK PETERSON (VP)
(858) 436-7662
Entity
Organization
Contact information
Practice address
18172 N 91ST AVE, PEORIA, AZ 85382-3001
(623) 974-5847
Mailing address
500 STEVENS AVE, SOLANA BEACH, CA 92075-2055
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410104
—
AZ
Enumeration date
03/01/2010
Last updated
03/01/2010
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