Organization
CHRIS RIDGE VILLAGE HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA WILLIAMSON (ADMINISTRATOR)
(602) 433-6300
Entity
Organization
Contact information
Practice address
6246 N 19TH AVE, PHOENIX, AZ 85015-1511
(602) 433-6300
(602) 433-5458
Mailing address
6246 N 19TH AVE, PHOENIX, AZ 85015-1511
(602) 433-6300
(602) 433-5458
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-367
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355976
—
AZ
Enumeration date
10/12/2005
Last updated
09/28/2007
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