19TH AVENUE OPERATIONS, LLC
Nursing at 19 Ave, Phoenix, AZ

License number
Arizona AL10013C
Category
Nursing
Type
Assisted Living Facility
License number
Arizona AL10014C
Category
Nursing
Type
Assisted Living Facility
License number
Arizona NCI-2694
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: TRACY L. CLARK JR.
Title: AUTHORIZED REPRESENTATIVE
Phone: (310) 337-1929
Address
Address 2
6246 N 19Th Ave, Phoenix, AZ 85015
1000 Corporate Pointe SUITE 100, Los Angeles, CA 90230
National Provider ID: 1649627423
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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