Organization
COPPER HEALTH ORO VALLEY LLC
Active
Other names
Copper Health Oro Valley
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY TERRENCE MCNELLIS (OWNER/MANAGER)
(612) 991-9062
Entity
Organization
Contact information
Practice address
1119 E RANCHO VISTOSO BLVD, ORO VALLEY, AZ 85755-9106
(520) 823-4669
Mailing address
3602 E GREENWAY RD, SUITE 104, PHOENIX, AZ 85032-4648
(602) 368-8203
(602) 368-8211
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI2725
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCI2725
ARIZONA DEPT. OF HEALTH SERVICES
AZ
Enumeration date
01/08/2014
Last updated
07/07/2015
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