Organization
SILVER RIDGE MANAGEMENT INC
Active
Other names
The Legacy Rehab & Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN CHARLES KIDDER (CEO)
(928) 718-4852
Entity
Organization
Contact information
Practice address
2812 SILVER CREEK RD, BULLHEAD CITY, AZ 86442-8309
(928) 763-1404
(928) 763-9795
Mailing address
2812 SILVER CREEK RD, BULLHEAD CITY, AZ 86442-8309
(928) 763-1404
(928) 763-9795
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-2664
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304755
—
AZ
Enumeration date
04/03/2007
Last updated
02/18/2011
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