OrganizationActive
19th Avenue Operations, LLC
NPI 1649627423 · Skilled Nursing Facility · Phoenix, AZ
Provider details
- NPI number
- 1649627423
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Tracy Clark, Authorized Representative(310) 337-1929
- License
- AL10014C (AZ)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Practice location
6246 N 19th Ave
Phoenix, AZ 85015-1511
Phone: (602) 433-6300
Fax: (602) 433-6458
Approximate (ZIP-level) locationGet directions
Mailing address
1000 Corporate Pointe
Culver City, CA 90230-7690
Other names (DBA / former)
- Doing business as
- The Palazzo
Registry dates
- Enumerated
- 2016-05-20
- Last updated
- 2017-01-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.