Provider Demographics
NPI:1962362541
Name:TUCSON ASSISTED LIVING RETREAT, LLC
Entity type:Organization
Organization Name:TUCSON ASSISTED LIVING RETREAT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCHAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-458-1385
Mailing Address - Street 1:250 S VOZACK LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-4539
Mailing Address - Country:US
Mailing Address - Phone:714-458-1385
Mailing Address - Fax:800-392-0662
Practice Address - Street 1:250 S VOZACK LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-4539
Practice Address - Country:US
Practice Address - Phone:714-458-1385
Practice Address - Fax:800-392-0662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility