Organization
SUN VALLEY LODGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL FAHEY (EXECUTIVE DIRECTOR)
(623) 933-0137
Entity
Organization
Contact information
Practice address
12415 N 103RD AVE, SUN CITY, AZ 85351-3509
(623) 933-0137
Mailing address
12415 N 103RD AVE, SUN CITY, AZ 85351-3509
(623) 933-0137
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-258
AZ
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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