# 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:** 1811527047
- **Authorized official:** DESIRE RUSINGIZWA BHT (PROGRAM DIRECTOR)
- **Authorized official phone:** (623) 877-3764

## Contact information

- **Practice address:** 6462 S 4TH ST, PHOENIX, AZ 85042-7604
- **Practice address phone:** (623) 399-7824
- **Practice address fax:** (855) 538-5652
- **Mailing address:** 6462 S 4TH ST, PHOENIX, AZ 85042-7604
- **Mailing address phone:** (623) 399-7824

## Taxonomy

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

## Other

- **Enumeration date:** 01/15/2020
- **Last updated:** 01/15/2020