Healthcare Provider Details

I. General information

NPI: 1790846855
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA CARE FACILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 S RURAL RD
TEMPE AZ
85283-2904
US

IV. Provider business mailing address

7485 OFFICE RIDGE CIR
EDEN PRAIRIE MN
55344-3690
US

V. Phone/Fax

Practice location:
  • Phone: 480-831-8660
  • Fax: 480-820-7663
Mailing address:
  • Phone: 952-941-0305
  • Fax: 952-941-0428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNCI-327
License Number StateAZ

VIII. Authorized Official

Name: NANCY GAVIN
Title or Position: ASSISTANT SECRETARY, TREASURER
Credential:
Phone: 952-941-0305