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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