Healthcare Provider Details

I. General information

NPI: 1740813401
Provider Name (Legal Business Name): BKD NORTH GLENDALE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6735 W HILLCREST BLVD
GLENDALE AZ
85310-5958
US

IV. Provider business mailing address

6735 W HILLCREST BLVD
GLENDALE AZ
85310-5958
US

V. Phone/Fax

Practice location:
  • Phone: 623-572-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JOANNE K LESKOWICZ
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 414-918-5000