Organization
OLIVE GROVE REAL ESTATE LLC
Active
Parent organization
STELLAR SENIOR LIVING LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
STELLAR SENIOR LIVING LLC
Authorized official
AARON BENTON (MEMBER)
(801) 495-7000
Entity
Organization
Contact information
Practice address
3014 E INDIAN SCHOOL RD, PHOENIX, AZ 85016-6887
(623) 505-4668
Mailing address
3014 E INDIAN SCHOOL RD, PHOENIX, AZ 85016-6887
(623) 505-4668
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9164C
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884722
—
AZ
Enumeration date
02/26/2014
Last updated
02/26/2014
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