Organization
QUILTED CARE LTD. CO, DBA PEPPERTREE SQUARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETTA KOSKOVICH (ADMINISTRATOR)
(623) 878-5115
Entity
Organization
Contact information
Practice address
10420 N 89TH AVE, PEORIA, AZ 85345-6453
(623) 878-5115
(623) 878-1604
Mailing address
10420 N 89TH AVE, PEORIA, AZ 85345-6453
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ALC-4673
AZ
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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