19TH AVENUE OPERATIONS, LLC

Skilled Nursing Facility

OIG CLEARNPI VERIFIED

Location

PHOENIX, AZ

Licensed since

2016

Rate

—

Federal identifiers

NPI registry number1649627423

Agency details

Medicare activity

StatusNo Medicare utilization on file — neutral.

Authorized official

NameTRACY CLARK

TitleAUTHORIZED REPRESENTATIVE

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