Provider Demographics
NPI:1730466962
Name:LA POSADA AT PARK CENTRE INC
Entity Type:Organization
Organization Name:LA POSADA AT PARK CENTRE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. OF HEALTHCARE SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLNACKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-648-8380
Mailing Address - Street 1:780 S PARK CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-5127
Mailing Address - Country:US
Mailing Address - Phone:520-625-2273
Mailing Address - Fax:
Practice Address - Street 1:780 S PARK CENTRE AVE
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-5127
Practice Address - Country:US
Practice Address - Phone:520-625-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL0553D251V00000X
261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251V00000XAgenciesVoluntary or Charitable