RUSSELL HAYS
Assisted Living, Mental Illness
Phoenix, Arizona
Provider NPI: 1649325432
Organization Information:Organization Name: RUSSELL HAYS
Practice Location:
3540 E CAMPO BELLO DR PHOENIX, AZ 85032 US
Tel: 602-626-7349 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:
3540 E CAMPO BELLO DR PHOENIX, AZ 85032 US
Tel: 602-626-7349 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3104A0625X | Nursing & Custodial Care Facilities Assisted Living Facility Assisted Living, Mental Illness | AZ | BH2775 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
866717 | AZ | 05 | |
AZ STATE LICENSE | BH2959 | AZ | 01 |
AZ STATE LICENSE | BH2775 | AZ | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin