Provider Demographics
NPI:1912400755
Name:SAPPHIRE OF TUCSON NURSING AND REHAB LLC
Entity Type:Organization
Organization Name:SAPPHIRE OF TUCSON NURSING AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-812-3648
Mailing Address - Street 1:18200 CICERO AVE
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-2911
Mailing Address - Country:US
Mailing Address - Phone:708-573-1100
Mailing Address - Fax:
Practice Address - Street 1:2900 E MILBER ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2097
Practice Address - Country:US
Practice Address - Phone:520-294-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility