Provider Demographics
NPI:1679892012
Name:DESERT CARE CONNECTIONS, LLC
Entity type:Organization
Organization Name:DESERT CARE CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/RN
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-228-1707
Mailing Address - Street 1:2405 W BARROW DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5802
Mailing Address - Country:US
Mailing Address - Phone:602-576-3421
Mailing Address - Fax:
Practice Address - Street 1:2405 W. BARROW DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:602-576-3421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH-6198311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ096798OtherALTCS SCAN