Organization
LIFESTREAM COMPLETE SENIOR LIVING INC
Active
Other names
LifeStream at Youngtown
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD ESTES (CHIEF FINANCIAL OFFICER)
(623) 933-3333
Entity
Organization
Contact information
Practice address
11527 W PEORIA AVE, YOUNGTOWN, AZ 85363-1640
(623) 933-4683
(623) 972-4993
Mailing address
11527 W PEORIA AVE, YOUNGTOWN, AZ 85363-1640
(623) 933-4683
(623) 972-4993
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALC4381
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493996
—
AZ
Enumeration date
03/12/2010
Last updated
05/21/2013
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