MEDICARE: SCL COLLEGE OF NURSING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1043068133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCL COLLEGE OF NURSING

Provider Business Mailing Address
First Line	:	14209 W VALLEY VIEW DR
Second Line	:
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-5053
Country	:	US
Telephone Number	:	480-215-9056
Fax Number	:

Provider Business Practice Location Address
First Line	:	7308 W GLASS LN
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-7008
Country	:	US
Telephone Number	:	480-215-9056
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELANGE NATHAN
Credential	:	PH.D.
Telephone Number	:	480-215-9056

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	06/15/2026

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