Organization
LIVE WELL ASSISTED LIVING
Active
Other names
LIVE WELL RESIDENTIAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DESIRE RUSINGIZWA BHT (PROGRAM DIRECTOR)
(623) 877-3764
Entity
Organization
Contact information
Practice address
6462 S 4TH ST, PHOENIX, AZ 85042-7604
(623) 399-7824
(855) 538-5652
Mailing address
6462 S 4TH ST, PHOENIX, AZ 85042-7604
(623) 399-7824
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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