Organization
AGUA FRIA SENIOR LIVING, LLC
Active
Organization
AGUA FRIA SENIOR LIVING, LLC
Active
Other names
The Mission at Agua Fria
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS HAMILTON (MANAGING MEMBER)
(480) 368-5755
Entity
Organization
Contact information
Practice address
8880 N 107TH AVE, PEORIA, AZ 85345-2908
(623) 266-0999
(623) 215-7703
Mailing address
14650 N 78TH WAY STE B, SCOTTSDALE, AZ 85260-2970
(602) 544-3195
(602) 553-7574
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
527346
—
AZ
01
—
AL10709C
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
04/07/2020
Last updated
04/07/2020
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