Organization
AC RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN DIKE RN (ADMINISTRATOR)
(480) 203-5862
Entity
Organization
Contact information
Practice address
2713 E VILLA RITA DR, PHOENIX, AZ 85032-1031
(480) 203-5862
Mailing address
2713 E VILLA RITA DR, PHOENIX, AZ 85032-1031
(480) 203-5862
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10547H
AZ
Other
Enumeration date
11/12/2017
Last updated
11/12/2017
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