Organization
SRCV-ROSA, LLC.
Active
Other names
Santa Rosa Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN D. BALLIET (ADMINISTRATOR)
(520) 795-1610
Entity
Organization
Contact information
Practice address
1650 N SANTA ROSA AVE, TUCSON, AZ 85712-4039
(520) 795-1610
(520) 319-8046
Mailing address
1650 N SANTA ROSA AVE, TUCSON, AZ 85712-4039
(520) 795-1610
(520) 319-8046
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI2621
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
792491
—
AZ
Enumeration date
08/13/2006
Last updated
05/15/2025
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