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Organization
ACTIVE ASSISTED LIVING, LLC
Active
Organization
ACTIVE ASSISTED LIVING, LLC
Active
Other names
Comfort Haven of Mesa
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN JAMES THARALSON (DIRECTOR)
(480) 461-8272
Entity
Organization
Contact information
Practice address
758 S TOLTEC, MESA, AZ 85204-3642
(480) 461-8272
(480) 461-4682
Mailing address
1235 S GILBERT RD, STE 3, PMB 83, MESA, AZ 85204-6005
(480) 461-8272
(480) 461-4682
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
ALH-4567
AZ
Other
Enumeration date
03/30/2007
Last updated
08/01/2007
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