Provider Demographics
NPI:1891200705
Name:TUCSON SENIOR CARE HOMES LLC
Entity Type:Organization
Organization Name:TUCSON SENIOR CARE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-231-9637
Mailing Address - Street 1:113 N AVENIDA DE SAN RAMON
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2111
Mailing Address - Country:US
Mailing Address - Phone:949-231-9637
Mailing Address - Fax:
Practice Address - Street 1:113 N AVENIDA DE SAN RAMON
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2111
Practice Address - Country:US
Practice Address - Phone:949-231-9637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL10609H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility