MEDICARE: VOP PHOENIX 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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1841902285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOP PHOENIX LLC

Provider Business Mailing Address
First Line	:	1739 W MYRTLE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-7968
Country	:	US
Telephone Number	:	602-841-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1739 W MYRTLE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-7968
Country	:	US
Telephone Number	:	602-841-2500
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	TOD MURRAY
Credential	:
Telephone Number	:	480-599-3459

Provider Enumeration Date	:	12/16/2022
Last Update Date	:	12/16/2022

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Directions to “VOP PHOENIX LLC ” Practice Location

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