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ASSISTED LIFESTYLES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DWIGHT C BOYD (CEO)
(928) 326-0044
Entity
Organization

Contact information

Practice address
4385 E WILD ELK TRL, FLAGSTAFF, AZ 86004-7921
(928) 326-0044
Mailing address
4385 E WILD ELK TRL, FLAGSTAFF, AZ 86004-7921
(928) 326-0044

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
AZ
347C00000X
Private Vehicle
AZ

Other

Enumeration date
02/02/2017
Last updated
02/02/2017
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