Organization
LIVE WELL ASSISTED LIVING LLC
Active
Parent organization
LIVE WELL ASSISTED LIVING LLC
Other names
LIVE WELL RESIDENTIAL CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVE WELL ASSISTED LIVING LLC
Authorized official
DESIRE RUSINGIZWA (PROGRAM DIRECTOR)
(602) 214-9544
Entity
Organization
Contact information
Practice address
12914 W SIERRA VISTA DR, GLENDALE, AZ 85307-1915
(602) 214-9544
(855) 538-5652
Mailing address
12634 W ESTERO LN, LITCHFIELD PARK, AZ 85340-5156
(602) 214-9544
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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