Organization
S-H OPCO PERIDOT, LLC
Active
Other names
The Peridot
Organization subpart
No
Provider details
NPI number
Authorized official
MARK OHLENDORF (CFO)
(414) 918-5000
Entity
Organization
Contact information
Practice address
211 BRADSHAW DR, PRESCOTT, AZ 86303-4405
(928) 777-5511
Mailing address
6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI 53214-5647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/01/2014
Last updated
08/01/2014
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