Organization
CASA DE VIDA LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT LEE BLUNT AL-MANAGER (CEO)
(602) 696-6249
Entity
Organization
Contact information
Practice address
7036 W PARKWAY DR, PHOENIX, AZ 85043-6921
(602) 696-6249
Mailing address
7036 W PARKWAY DR, PHOENIX, AZ 85043-6921
(602) 696-6249
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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