Organization
ADVANCED SUPPORTED LIVING SERVICES, LLC
Active
Organization
ADVANCED SUPPORTED LIVING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES CHURCHILL RN (CHIEF EXECUTIVE OFFICER)
(480) 548-7446
Entity
Organization
Contact information
Practice address
20403 N LAKE PLEASANT RD, SUITE 117-232, PEORIA, AZ 85382-9702
(480) 548-7446
(480) 907-1744
Mailing address
20403 N LAKE PLEASANT RD, SUITE 117-232, PEORIA, AZ 85382-9702
(480) 548-7446
(480) 907-1744
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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