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NPI Code Detail

MEDICARE: HIGHLAND HEALTHCARE LLC

MEDICARE: HIGHLAND HEALTHCARE LLC
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
1314000000XSkilled Nursing Facility20034076AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811989866
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND HEALTHCARE LLC
Provider Business Mailing Address
First Line : 4635 N 14TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4016
Country : US
Telephone Number : 602-264-9039
Fax Number : 602-264-1017
Provider Business Practice Location Address
First Line : 4635 N 14TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4016
Country : US
Telephone Number : 602-264-9039
Fax Number :
Authorized Official
Title or Position : TREASURER
Name : MS. SOON BURNAM
Credential :
Telephone Number : 949-540-1249
Provider Enumeration Date : 08/16/2005
Last Update Date : 02/16/2021

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Directions to “HIGHLAND HEALTHCARE LLC ” Practice Location

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