Organization
AC ASSISTED LIVING
Active
Other names
AC ASSISTED LIVING 3 LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PAT OVERTON (ADMIN ASSIST)
(310) 704-3504
Entity
Organization
Contact information
Practice address
2101 E ASH ST, GLOBE, AZ 85501-2034
(480) 203-5862
Mailing address
2101 E ASH ST, GLOBE, AZ 85501-2034
(480) 203-5862
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AL11342H
—
AZ
Enumeration date
01/29/2020
Last updated
01/29/2020
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