| Ponderosa Senior Assisted Living, Llc | |
|
4490 N Bellemont Springs Bellemont AZ 86015 | |
| (928) 213-1187 | |
| Not Available |
| Full Name | Ponderosa Senior Assisted Living, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 4490 N Bellemont Springs, Bellemont, Arizona |
| Authorized Official Name and Position | Lisa E Kennedy (OWNER) |
| Authorized Official Contact | 9282131187 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponderosa Senior Assisted Living, Llc Po Box 16193 Bellemont AZ 86015 Ph: (928) 213-1187 | Ponderosa Senior Assisted Living, Llc 4490 N Bellemont Springs Bellemont AZ 86015 Ph: (928) 213-1187 |
| NPI Number | 1841474723 |
|---|---|
| Provider Enumeration Date | 12/27/2007 |
| Last Update Date | 12/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841474723 | NPI | - | NPPES |
| ALH6417 | Other | AZ | ASSISTED LIVING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Arizona) | Primary |
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