Organization
CHRISTIAN CARE NURSING CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN S NORRIS (CHIEF EXECUTIVE OFFICER)
(602) 443-5411
Entity
Organization
Contact information
Practice address
11812 N 19TH AVE, PHOENIX, AZ 85029-3536
(602) 861-3241
(602) 943-6459
Mailing address
PO BOX 83210, PHOENIX, AZ 85071-3210
(602) 861-3241
(602) 943-6459
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCIR332
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040270
—
AZ
Enumeration date
09/01/2005
Last updated
01/08/2010
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