Organization
ASSISTED SENIOR LIVING CARE, LLC
Active
Other names
Assisted Senior Living Care, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISA RIADI (DIRECTOR)
(219) 985-4433
Entity
Organization
Contact information
Practice address
4149 E GREENWAY CIR, MESA, AZ 85205-4036
(708) 237-9000
(708) 237-1577
Mailing address
8550 S HARLEM AVE STE G, BRIDGEVIEW, IL 60455-1775
(219) 985-4433
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
473072
—
AZ
05
—
473403
—
AZ
Enumeration date
02/20/2019
Last updated
02/20/2019
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