Organization
COPPER HEIGHTS
Active
Other names
Legacy Senior Management, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON R GUINN (A/R COORDINATOR)
(602) 368-8203
Entity
Organization
Contact information
Practice address
152 N 56TH ST, MESA, AZ 85205-8718
(480) 985-0680
(480) 396-6231
Mailing address
152 N 56TH ST, MESA, AZ 85205-8718
(480) 985-0680
(480) 396-6231
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALC-6182
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212195
—
AZ
Enumeration date
02/18/2009
Last updated
02/18/2009
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