Provider Demographics
NPI:1104113505
Name:C&R HEALTHCARE GROUP, LLC.
Entity type:Organization
Organization Name:C&R HEALTHCARE GROUP, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:PORTER
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-264-0995
Mailing Address - Street 1:3319 S MERCY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0400
Mailing Address - Country:US
Mailing Address - Phone:480-729-6500
Mailing Address - Fax:480-353-2946
Practice Address - Street 1:3319 S MERCY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0400
Practice Address - Country:US
Practice Address - Phone:480-729-6500
Practice Address - Fax:480-729-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ035285Medicare Oscar/Certification