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
6426 S 38TH DR, PHOENIX, AZ 85041-6217
(602) 807-8961
Mailing address
6426 S 38TH DR, PHOENIX, AZ 85041-6217
(602) 807-8961
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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