Provider Demographics
NPI:1134929375
Name:APEX OF THE GILA VALLEY LLC
Entity type:Organization
Organization Name:APEX OF THE GILA VALLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MULLENEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-322-1770
Mailing Address - Street 1:PO BOX 1281
Mailing Address - Street 2:
Mailing Address - City:THATCHER
Mailing Address - State:AZ
Mailing Address - Zip Code:85552-1281
Mailing Address - Country:US
Mailing Address - Phone:928-322-1770
Mailing Address - Fax:928-792-2810
Practice Address - Street 1:3150 E. MAIN ST.
Practice Address - Street 2:
Practice Address - City:THATCHER
Practice Address - State:AZ
Practice Address - Zip Code:85552
Practice Address - Country:US
Practice Address - Phone:928-322-1770
Practice Address - Fax:928-792-2810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility