LIVE WELL ASSISTED LIVING NPI 1528586195

NPI Information

NPI: 1528586195
Provider Name: LIVE WELL ASSISTED LIVING

Doing Business As: LIVE WELL RESIDENTIAL CARE

Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
12634 W ESTERO LN
LITCHFIELD PARK, AZ
ZIP 85340
Phone: (623) 877-3293
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LIVE WELL ASSISTED LIVING is a residential treatment facility, intellectual and/or developmental disabilities in Litchfield Park, AZ. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. LIVE WELL ASSISTED LIVING NPI is 1528586195. The provider is registered as an organization entity type.
The provider Is Doing Business As Live Well Residential Care.

The provider's business location address is:

12634 W ESTERO LN
LITCHFIELD PARK, AZ
ZIP 85340-156
Phone: (623) 877-3293
Fax: (855) 538-5652

The provider's authorized official is Desire Rusingizwa .
The authorized official title is Program Director and has the following contact phone number (602) 214-9544.

The enumeration date for this NPI number is 9/5/2017 and was last updated on 9/5/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		BH-5157	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	860056	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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