Provider Demographics
NPI:1073372033
Name:COOLIDGE LEGACY AT SCOTTSDALE
Entity Type:Organization
Organization Name:COOLIDGE LEGACY AT SCOTTSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIOREL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURESAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-738-7093
Mailing Address - Street 1:22365 N 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-5919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7556 E COOLIDGE ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-1562
Practice Address - Country:US
Practice Address - Phone:623-746-6635
Practice Address - Fax:623-537-1690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility