Organization
LSREF GOLDEN OPS UE (AZ), LLC
Active
Other names
Amethyst Gardens Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
WICK PETERSON (VP)
(858) 436-7662
Entity
Organization
Contact information
Practice address
18170 N 91ST AVE, PEORIA, AZ 85382-0866
(623) 974-5848
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
—
418044
—
AZ
Enumeration date
02/16/2010
Last updated
02/16/2010
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