Organization
VINTAGE TIME LLC
Active
Other names
Hummingbird House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PRISCILLA C CULP RN MS (OWNER/MANAGER)
(253) 225-1474
Entity
Organization
Contact information
Practice address
1448 HUMMINGBIRD LN, SIERRA VISTA, AZ 85635-5443
(520) 335-2001
(520) 335-2001
Mailing address
26 E KAYETAN DR, SIERRA VISTA, AZ 85635-1116
(253) 225-1474
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AL7415H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429252
—
AZ
Enumeration date
06/28/2013
Last updated
06/28/2013
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