Organization
EXTENDED CARE PORTFOLIO MULTISTATE POOL TENANT, LLC
Active
Parent organization
EXTENDED CARE PORTFOLIO TENANT, LLC
Other names
Encore Senior Village at Paradise Valley
Organization subpart
Yes
Provider details
NPI number
Legal business name
EXTENDED CARE PORTFOLIO TENANT, LLC
Authorized official
PETER RICHARDSON (CONTROLLER)
(503) 905-3303
Entity
Organization
Contact information
Practice address
16621 N 38TH ST, PHOENIX, AZ 85032-2102
(602) 787-0800
Mailing address
6400 SE LAKE RD, SUITE 400, MILWAUKIE, OR 97222-2129
(503) 905-3303
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALC-6667
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
358816
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
AZ
Enumeration date
05/20/2009
Last updated
05/20/2009
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