Organization
SIERRA BLANCA REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARVEY F PELOVSKY NURSING HOME ADMINIS (OWNER)
(928) 978-0520
Entity
Organization
Contact information
Practice address
3401 N LOCKWOOD DR, LAKESIDE, AZ 85929
(928) 368-2060
(928) 368-2061
Mailing address
3401 N LOCKWOOD DR, LAKESIDE, AZ 85929
(928) 368-2060
(928) 368-2061
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
AZ
Other
Enumeration date
05/24/2010
Last updated
02/02/2011
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