Organization
INFINIA AT DOUGLAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT ROBERTSON (OWNER)
(801) 295-8000
Entity
Organization
Contact information
Practice address
1400 N SAN ANTONIO AVE, DOUGLAS, AZ 85607-2434
(520) 364-7937
(520) 805-9146
Mailing address
1400 N SAN ANTONIO AVE, DOUGLAS, AZ 85607-2434
(520) 364-7937
(520) 805-9146
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-388
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
707416
—
AZ
Enumeration date
06/28/2005
Last updated
08/22/2020
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