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General NPI Number Information
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NPI Number | 1164326419
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Entity Type | Organization
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Legal Business Name | VHG WINSLOW AZ OPCO LLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 826 W DESMOND ST
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City | WINSLOW
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State | AZ
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Zip | 86047-2321
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Country | US
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Telephone | 928-289-4678
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Fax |
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Provider Business Mailing Address
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Address Line | 2 RITZ CARLTON DR STE 202
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City | DANA POINT
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State | CA
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Zip | 92629-4245
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Country | US
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Telephone | 949-355-3795
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. BRYAN FOULGER
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Credential |
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Telephone | 949-355-3795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | NULL
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