# ACTIVE ASSISTED LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Comfort Haven of Mesa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629198858
- **Authorized official:** MR. STEVEN JAMES THARALSON (DIRECTOR)
- **Authorized official phone:** (480) 461-8272

## Contact information

- **Practice address:** 758 S TOLTEC, MESA, AZ 85204-3642
- **Practice address phone:** (480) 461-8272
- **Practice address fax:** (480) 461-4682
- **Mailing address:** 1235 S GILBERT RD, STE 3, PMB 83, MESA, AZ 85204-6005
- **Mailing address phone:** (480) 461-8272
- **Mailing address fax:** (480) 461-4682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | ALH-4567 | AZ | Yes |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 08/01/2007