Organization
AVISTA SENIOR LIVING DESERT SPRINGS, LLC
Active
Other names
Avista Senior Living North Mountain
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE FINE (AUTHORIZED AGENT)
(480) 244-9173
Entity
Organization
Contact information
Practice address
350 E EVA ST, PHOENIX, AZ 85020-2564
(602) 997-6224
(602) 944-4199
Mailing address
350 E EVA ST, PHOENIX, AZ 85020-2564
(602) 997-6224
(602) 944-4199
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8638C
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
677385
—
AZ
Enumeration date
06/13/2018
Last updated
06/13/2018
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