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General NPI Number Information
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NPI Number | 1699559195
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE AZ OPCO LLC
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 2620 N 68TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85257-1202
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Country | US
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Telephone | 623-462-2803
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 LAKEWOOD ROAD
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City | TOMS RIVER
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State | NJ
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Zip | 08755
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ISAAC RAMI
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Credential |
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Telephone | 201-928-7800
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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 |
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