Organization
LIVE WELL ASSISTED LIVING LLC
Active
Other names
LIVE WELL RESIDENTIAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DESIRE RUSINGIZWA (PROGRAM DIRECTOR)
(623) 877-3764
Entity
Organization
Contact information
Practice address
9210 W LOOW BEND LANE, PHOENIX, AZ 85037
(602) 214-9544
Mailing address
12634 W ESTERO LN, LITCHFIELD PARK, AZ 85340-5156
(602) 214-9544
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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