# LIVE WELL ASSISTED LIVING

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LIVE WELL RESIDENTIAL CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528586195
- **Authorized official:** DESIRE RUSINGIZWA (PROGRAM DIRECTOR)
- **Authorized official phone:** (602) 214-9544

## Contact information

- **Practice address:** 12634 W ESTERO LN, LITCHFIELD PARK, AZ 85340-5156
- **Practice address phone:** (623) 877-3293
- **Practice address fax:** (855) 538-5652
- **Mailing address:** 10258 W WINDSOR BLVD, GLENDALE, AZ 85307-4124
- **Mailing address phone:** (623) 877-3293
- **Mailing address fax:** (855) 538-5652

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | BH-5157 | AZ | Yes |

## Other

- **Enumeration date:** 09/05/2017
- **Last updated:** 09/05/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 860056 | — | AZ |