Organization
THE BEATITUDES CAMPUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAMMY CLEVENGER (CONTROLLER)
(602) 995-2611
Entity
Organization
Contact information
Practice address
1616 W GLENDALE AVE, PHOENIX, AZ 85021-8948
(602) 995-2611
(602) 995-6127
Mailing address
1616 W GLENDALE AVE, PHOENIX, AZ 85021-8948
(602) 995-2611
(602) 995-6127
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
ALC-4281
AZ
314000000X
Skilled Nursing Facility
Primary
NCI-256
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040163
—
AZ
Enumeration date
10/25/2005
Last updated
11/04/2008
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