Organization
LAKEVIEW ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY ROSS (OWNER)
(480) 415-4447
Entity
Organization
Contact information
Practice address
20044 N 68TH DR, GLENDALE, AZ 85308-5594
(480) 415-4447
Mailing address
20044 N 68TH DR, GLENDALE, AZ 85308-5594
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659851939
—
AZ
05
—
843312
—
AZ
Enumeration date
02/11/2019
Last updated
02/11/2019
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