Organization
ALLEGIANT HEALTHCARE OF PHOENIX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA CODY (ADMINISTRATOR)
(602) 253-4570
Entity
Organization
Contact information
Practice address
1880 E VAN BUREN ST, PHOENIX, AZ 85006-3742
(602) 253-4570
Mailing address
1880 E VAN BUREN ST, PHOENIX, AZ 85006-3742
(480) 417-7594
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
3140N1450X
Pediatric Skilled Nursing Facility
—
—
Other
Enumeration date
07/27/2017
Last updated
06/02/2021
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