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General NPI Number Information
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NPI Number | 1720733801
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Entity Type | Organization
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Legal Business Name | COOLIDGE LEGACY AT SCOTTSDALE LLC
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 7556 E COOLIDGE ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-1562
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Country | US
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Telephone | 480-784-7444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2252
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City | SCOTTSDALE
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State | AZ
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Zip | 85252-2252
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Country | US
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Telephone | 480-784-7444
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | AYALI CASSEL
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Credential |
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Telephone | 480-784-7444
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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 |
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License Number State |
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