Organization
NORTH MOUNTAIN HEALTHCARE LLC
Active
Other names
Coronado Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
11411 N 19TH AVE, PHOENIX, AZ 85029-3642
(602) 256-7500
(602) 943-7697
Mailing address
11411 N 19TH AVE, PHOENIX, AZ 85029-3642
(602) 256-7500
(602) 943-7697
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-2637
AZ
Other
Enumeration date
08/22/2005
Last updated
02/16/2021
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