Active Assisted Living, Llc in Mesa - Residential Treatment Facility, Physical Disabilities
Active Assisted Living, Llc - NPI 1629198858
Active Assisted Living, Llc is a Residential Treatment Facility, Physical Disabilities in Mesa, Arizona. Active Assisted Living, Llc practices all healthcare services and medical treatments related to Residential Treatment Facility, Physical Disabilities. The NPI Number for Active Assisted Living, Llc is 1629198858. The last update date is 2007-08-01.
Active Assisted Living, Llc's current location address is 1235 S Gilbert Rd, Mesa, Arizona. You can contact this provider via phone number 4804618272 and fax number 4804614682. The mailing address for Active Assisted Living, Llc is 1235 S Gilbert Rd, Mesa, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Active Assisted Living, Llc |
|---|---|
| Address | 1235 S Gilbert Rd, Mesa, Arizona |
| Phone Number | 4804618272 |
| Fax Number | 4804614682 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR |
|---|---|
| Authorized Official Name | Tharalson James Steven |
| Telephone Number | 4804618272 |
NPI Number Detail
| NPI Number | 1629198858 |
|---|---|
| Provider Enumeration Date | 2007-03-30 |
| Last Updated Date | 2007-08-01 |
Provider Mailing Address Detail
| Address | 1235 S Gilbert Rd |
|---|---|
| City | Mesa |
| State | Arizona (AZ) |
| Post Code | 852046005 |
| Phone Number | 4804618272 |
| Fax Number | 4804614682 |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Physical Disabilities |
|---|---|
| Taxonomy | 320700000X |
| Licence No | ALH-4567 |
|
Definition: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| ALH-4567 | AZ | ASSISTED LIVING LICENSE |
Post Comment/ Review Below
What is the unique identifier code issued to Active Assisted Living, Llc by the Centers for Medicare & Medicaid Services (CMS)?
The Active Assisted Living, Llc has been assigned the NPI (National Provider Identifier) 1629198858. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Active Assisted Living, Llc?
The Active Assisted Living, Llc is physically situated at 1235 S Gilbert Rd, in the city of Mesa, state of AZ, with the postal code 852046005.
What is Active Assisted Living, Llc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Active Assisted Living, Llc is Residential Treatment Facility, Physical Disabilities, and the taxonomy code that categorizes this field of expertise is 320700000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1629198858 to Active Assisted Living, Llc?
The Centers for Medicare & Medicaid Services originally issued the 1629198858 to Active Assisted Living, Llc on 2007-03-30.
As of what date were the details related to Active Assisted Living, Llc most recently updated or revised?
The information pertaining to Active Assisted Living, Llc, including its address, specialty, and other relevant details, was last updated or revised on 2007-08-01.