Organization
STELLAR HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELVIN D SMITH (VICE PRESIDENT)
(480) 661-1164
Entity
Organization
Contact information
Practice address
9362 E SHARON DR, SCOTTSDALE, AZ 85260-7426
(480) 634-4004
(480) 474-4243
Mailing address
9255 E DESERT TRL, SCOTTSDALE, AZ 85260-4543
(480) 661-1164
(480) 661-1164
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
DDH1574
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152318
AHCCCS
AZ
Enumeration date
08/31/2007
Last updated
07/30/2010
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