Provider Demographics
NPI:1992226948
Name:SOLTERRA DEER VALLEY OPERATIONS, LLC
Entity type:Organization
Organization Name:SOLTERRA DEER VALLEY OPERATIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:INGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-621-4609
Mailing Address - Street 1:14650 N 78TH WAY STE B
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2970
Mailing Address - Country:US
Mailing Address - Phone:1602-544-3195
Mailing Address - Fax:
Practice Address - Street 1:2641 W UNION HILLS DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-5000
Practice Address - Country:US
Practice Address - Phone:602-603-7480
Practice Address - Fax:602-603-7485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL10387310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility