Provider Demographics
NPI:1508207085
Name:POINTE HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:POINTE HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-840-0937
Mailing Address - Street 1:14650 N 78TH WAY
Mailing Address - Street 2:BLDG B
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3201
Mailing Address - Country:US
Mailing Address - Phone:602-544-3196
Mailing Address - Fax:602-553-7574
Practice Address - Street 1:1501 E ORANGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5130
Practice Address - Country:US
Practice Address - Phone:602-544-3196
Practice Address - Fax:602-553-7574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZNCI-2711314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ886336Medicaid
AZ886336Medicaid