Provider Demographics
NPI:1790069870
Name:BNR CORPORATION
Entity Type:Organization
Organization Name:BNR CORPORATION
Other - Org Name:CAREFREE ASSISTED LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-639-3860
Mailing Address - Street 1:22 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-5440
Mailing Address - Country:US
Mailing Address - Phone:928-639-3860
Mailing Address - Fax:928-649-0410
Practice Address - Street 1:22 S 7TH ST
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-5440
Practice Address - Country:US
Practice Address - Phone:928-639-3860
Practice Address - Fax:928-649-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL5008C310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ262760OtherAHCCCS