- Enrollment id
- O20040709000272
- Enrollment state
- AZ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1053306811
- Multiple npi flag
- N
- Ccn
- 035087
- Associate id
- 9739167594
- Organization name
- RADIANT HILLS HEALTH ASSOCIATES LLC
- Doing business as name
- NORTH MOUNTAIN MEDICAL & REHABILITATION CENTER
- Incorporation date
- 2004-06-17
- Incorporation state
- NV
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- NORTH MOUNTAIN MEDICAL AND REHABILITATION CENTER
- Affiliation entity name
- THE ENSIGN GROUP
- Affiliation entity id
- 507
- Address line 1
- 9155 N 3RD ST
- City
- PHOENIX
- State
- AZ
- Zip code
- 850202410