BREA PEORIA, LLC
Alzheimer Center
Peoria, Arizona
Provider NPI: 1982931002
Organization Information:Organization Name: BREA PEORIA, LLC
Practice Location:
9296 W UNION HILLS DR PEORIA, AZ 85382 US
Tel: 623-362-2700 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
9296 W UNION HILLS DR PEORIA, AZ 85382 US
Tel: 623-362-2700 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | AZ | AL6220C |
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | AZ | AL6220C |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
AZ AHCCCS | 970635 | AZ | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin