Provider Demographics
NPI:1508274846
Name:RACC LLC
Entity Type:Organization
Organization Name:RACC LLC
Other - Org Name:RAZINN ASSISTED CARE CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUSLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-803-9575
Mailing Address - Street 1:37 W PASADENA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-2086
Mailing Address - Country:US
Mailing Address - Phone:602-400-6488
Mailing Address - Fax:855-288-9241
Practice Address - Street 1:37 W PASADENA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-2086
Practice Address - Country:US
Practice Address - Phone:602-400-6488
Practice Address - Fax:855-288-9241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp