Provider Demographics
NPI:1962251330
Name:THE SERVANT GROUP LLC
Entity type:Organization
Organization Name:THE SERVANT GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BELTON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:414-544-8986
Mailing Address - Street 1:11836 W MORNING VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4523
Mailing Address - Country:US
Mailing Address - Phone:414-544-8986
Mailing Address - Fax:
Practice Address - Street 1:3335 N TOWER RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2700
Practice Address - Country:US
Practice Address - Phone:414-544-8986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility