| Organization Name: | ARCHIE HENDRICKS SR. SKILLED NURSING FASCILITY |
| NPI Number: | 1093838658 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONCETTA MARIE TYNAN (ADMINISTRATOR) |
| Mailing Address: | Federal Route 15 Mile Post 9 Sells |
| State: | AZ US |
| Postal Code: | 856349744 |
| Phone Number: | 5203611800 |
| Fax Number: | 5203613656 |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 07/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |