Organization
PALM VIEW ASSISTED LIVING, LLC.
Active
Other names
Palm View
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD NOWELL (OWNER, EXECUTIVE DIRECTOR)
(520) 571-8120
Entity
Organization
Contact information
Practice address
11650 E SPEEDWAY BLVD, TUCSON, AZ 85748-2016
(520) 722-9223
(520) 721-9379
Mailing address
11650 E SPEEDWAY BLVD, TUCSON, AZ 85748-2016
(520) 722-9223
(520) 721-9379
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
07646057
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
912312
AHCCCS PROVIDER ID
AZ
Enumeration date
01/08/2009
Last updated
01/08/2009
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