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General NPI Number Information
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NPI Number | 1700337680
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Entity Type | Organization
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Legal Business Name | COLTEN ADULT CARE, LLC
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 14203 N 68TH PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-3401
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Country | US
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Telephone | 480-483-4747
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Fax | 480-483-6845
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Provider Business Mailing Address
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Address Line | 13951 N SCOTTSDALE RD SUITE #121
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-3452
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Country | US
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Telephone | 480-483-4747
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Fax | 480-483-6845
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | PETER COLTEN
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Credential |
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Telephone | 480-483-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL7739H
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License Number State | AZ
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