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General NPI Number Information
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NPI Number | 1740807270
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Entity Type | Organization
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Legal Business Name | THE SERVANT GROUP LLC
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 15278 W BELL RD
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City | SURPRISE
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State | AZ
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Zip | 85374-3100
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Country | US
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Telephone | 623-440-2681
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Fax | 623-440-4352
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Provider Business Mailing Address
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Address Line | PO BOX 8131
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City | SURPRISE
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State | AZ
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Zip | 85374-0118
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Country | US
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Telephone | 623-440-2681
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Fax | 623-440-4352
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Authorized Official
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Title or Position | CEO
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Name | DR. STEPHANIE BELTON
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Credential | EDD
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Telephone | 623-440-2682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #3
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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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