Organization
ELDERCARE SPRINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SHANE FISHER (OWNER)
(928) 635-6750
Entity
Organization
Contact information
Practice address
3620 N WALKER ST, FLAGSTAFF, AZ 86004-2031
(928) 635-6750
(928) 526-5169
Mailing address
PO BOX 30354, FLAGSTAFF, AZ 86003-0354
(928) 635-6750
(928) 526-5169
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
618181
—
AZ
Enumeration date
05/16/2019
Last updated
05/16/2019
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