# AZ ADVANCED CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** West Lane Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447645833
- **Authorized official:** REBECCA T. SIDDIQUI (ADMINISTRATOR)
- **Authorized official phone:** (602) 332-0780

## Contact information

- **Practice address:** 3137 W LANE AVE, PHOENIX, AZ 85051-6522
- **Practice address phone:** (602) 332-0780
- **Practice address fax:** (877) 517-2224
- **Mailing address:** 3137 W LANE AVE, PHOENIX, AZ 85051-6522
- **Mailing address phone:** (602) 332-0780
- **Mailing address fax:** (877) 517-2224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | AL9510H | AZ | Yes |

## Other

- **Enumeration date:** 04/02/2015
- **Last updated:** 04/02/2015