Organization
LIVING 365 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MUHAMMAD (OWNER)
(623) 248-4342
Entity
Organization
Contact information
Practice address
2267 S 173RD DR, GOODYEAR, AZ 85338-1961
(623) 248-4342
(623) 248-6096
Mailing address
11250 E QUICKSILVER AVE, MESA, AZ 85212-4005
(803) 600-6939
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251J00000X
Nursing Care Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
09/18/2019
Last updated
12/16/2019
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