Provider Demographics
NPI:1427896174
Name:HERITAGE HEALTH ARIZONA
Entity type:Organization
Organization Name:HERITAGE HEALTH ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-577-7800
Mailing Address - Street 1:9009 N FOOTHILS MANOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253
Mailing Address - Country:US
Mailing Address - Phone:480-577-7800
Mailing Address - Fax:
Practice Address - Street 1:9009 N FOOTHILS MANOR DRIVE
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253
Practice Address - Country:US
Practice Address - Phone:480-577-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility