Organization
LA SOLANA CARE AND REHAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM SCOTT THOMAS (SYSTEMS ADMINISTRATOR)
(801) 296-5106
Entity
Organization
Contact information
Practice address
1400 N SAN ANTONIO AVE, DOUGLAS, AZ 85607-2434
(520) 364-7937
(520) 805-9146
Mailing address
1400 N SAN ANTONIO AVE, DOUGLAS, AZ 85607-2434
(520) 364-7937
(520) 805-9146
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-388
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
707416
—
AZ
Enumeration date
02/11/2009
Last updated
02/11/2009
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