Boulder Gardens Assistant Living, Llc

LBN: Boulder Gardens Assistant Living, Llc
Boulder Gardens Assistant Living, Llc is an health care organization with primary practice located at 860 Dougherty St , Prescott AZ 86305-1841. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Boulder Gardens Assistant Living, Llc can be contacted via phone (928) 778-9667, or through Zimmerman, Carl via phone (520) 352-3019.

Contact Information

Primary practice address
860 Dougherty St Prescott AZ 86305-1841
Phone: (928) 778-9667
Fax: (520) 393-1044
Website:
Map and Directions
Authorized official contact:
Name: Zimmerman, Carl
Phone: (520) 352-3019

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X AL1494C Arizona

Profile Details

NPI number 1114262292
LBN Legal business name Boulder Gardens Assistant Living, Llc
DBA Doing business as
Authorized official Zimmerman, Carl
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2012
Last updated Nov 30th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114262292 NPPES
Arizona Other AL1494C STATE LICENSE

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