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THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Assisted Living Facility

Prescott, Arizona

Provider NPI: 1588645600

Organization Information:
Organization Name:  THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY


Practice Location:
3191 ASTER DR  PRESCOTT, AZ 86305 US
Tel: 928-443-9999  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility

Other Provider Identifiers:

IssuerNumberStateType
487125AZ05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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