Provider Demographics
NPI:1063725117
Name:LCS-WESTMINSTER PARTNERSHIP IV LLP
Entity type:Organization
Organization Name:LCS-WESTMINSTER PARTNERSHIP IV LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT OF MGR MBR
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:D
Authorized Official - Last Name:MERCURIS PENDROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4527
Mailing Address - Street 1:4555 E MAYO BLVD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-6952
Mailing Address - Country:US
Mailing Address - Phone:480-384-5800
Mailing Address - Fax:
Practice Address - Street 1:4555 E MAYO BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-6952
Practice Address - Country:US
Practice Address - Phone:480-384-5800
Practice Address - Fax:480-384-5670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ035279Medicare Oscar/Certification