Organization
LIFESTREAM COMPLETE SENIOR LIVING AT THUNDERBIRD INC
Active
Other names
LifeStream at Thunderbird
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROD KEMP (CHIEF FINANCIAL OFFICER)
(623) 933-3333
Entity
Organization
Contact information
Practice address
13617 N 55TH AVE, GLENDALE, AZ 85304-4701
(602) 938-5500
(602) 843-9530
Mailing address
13617 N 55TH AVE, GLENDALE, AZ 85304-4701
(602) 938-5500
(602) 843-9530
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALC-4809
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
622854
—
AZ
05
—
E2103020
—
AZ
05
—
EVC00600003119
—
AZ
Enumeration date
01/19/2006
Last updated
06/29/2012
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