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General NPI Number Information
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NPI Number | 1932479946
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Entity Type | Organization
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Legal Business Name | CHANDLER FAIRVIEW PARTNERS LLC
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2200 WEST FAIRVIEW ST.
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City | CHANDLER
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State | AZ
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Zip | 85224
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Country | US
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Telephone | 480-634-4191
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Fax |
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Provider Business Mailing Address
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Address Line | 111 MARKET ST NE STE 200
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City | OLYMPIA
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State | WA
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Zip | 98501
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Country | US
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Telephone | 360-867-1900
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Fax | 360-867-1956
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Authorized Official
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Title or Position | OWNER
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Name | MR. EMMETT AARON KOELSCH
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Credential |
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Telephone | 360-867-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | AL8609C
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License Number State | AZ
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Taxonomy #2
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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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