Organization
SLO RIDGECREST LLC
Active
Other names
RidgeCrest Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COLLEEN HELEN SWEET (MANAGING MEMBER)
(480) 797-9948
Entity
Organization
Contact information
Practice address
16640 N 38TH ST, PHOENIX, AZ 85032-2103
(602) 482-6671
(602) 482-3541
Mailing address
16640 N 38TH ST, PHOENIX, AZ 85032-2103
(602) 482-6671
(602) 482-3541
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NCI2651
AZ
314000000X
Skilled Nursing Facility
Primary
NCI2651
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
924771
—
AZ
Enumeration date
10/10/2005
Last updated
02/12/2013
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