Provider Demographics
NPI:1346006194
Name:SAINT ANNE RESIDENTIAL CARE CORP.
Entity Type:Organization
Organization Name:SAINT ANNE RESIDENTIAL CARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLAISE
Authorized Official - Middle Name:BUQUIRAN
Authorized Official - Last Name:DELA PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-546-4584
Mailing Address - Street 1:3158 KINGSPOINT AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-1977
Mailing Address - Country:US
Mailing Address - Phone:702-433-9470
Mailing Address - Fax:855-745-6464
Practice Address - Street 1:3158 KINGSPOINT AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-1977
Practice Address - Country:US
Practice Address - Phone:702-433-9470
Practice Address - Fax:855-745-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home