03D0721433 CLIA NUMBER - SNH AZ TENANT LLC DBA PUEBLO NORTE SENIOR LIVING COMMUNITY

Laboratory Demographics

CLIA Number: 03D0721433

Facility Name: SNH AZ TENANT LLC DBA PUEBLO NORTE SENIOR LIVING COMMUNITY

Facility Address:
7100 EAST MESCAL STREET
SCOTTSDALE, AZ
ZIP 85254
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Facility Phone Number: 480 948-3990

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1801442637

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	03D0721433
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	SNH AZ TENANT LLC DBA PUEBLO NORTE SENIOR LIVING COMMUNITY
Street	7100 EAST MESCAL STREET
City	SCOTTSDALE
State	AZ
ZIP	85254
Phone	480 948-3990
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024