Organization
AC ASSISTED LIVING
Active
Organization
AC ASSISTED LIVING
Active
Parent organization
AL11076H
Other names
AC ASSISTED LIVING 2
Organization subpart
Yes
Provider details
NPI number
Legal business name
AL11076H
Authorized official
HELEN DIKE (PRESIDENT)
(480) 203-6862
Entity
Organization
Contact information
Practice address
410 W EUCLID AVE, GLOBE, AZ 85501-2412
(480) 203-5862
Mailing address
14848 N 15TH DR, PHOENIX, AZ 85023-5181
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AL11268H
—
AZ
Enumeration date
11/13/2019
Last updated
11/27/2023
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