Healthcare Provider Details

I. General information

NPI: 1992098420
Provider Name (Legal Business Name): QUALITY CARE ASSISTED LIVING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 E MONTEBELLO AVE
APACHE JUNCTION AZ
85119-7651
US

IV. Provider business mailing address

PO BOX 1688
APACHE JUNCTION AZ
85117-4066
US

V. Phone/Fax

Practice location:
  • Phone: 480-861-0306
  • Fax: 480-983-5705
Mailing address:
  • Phone: 480-861-0306
  • Fax: 480-983-5705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number311ZA0620X
License Number StateAZ

VIII. Authorized Official

Name: MR. DAVID L RHOADES
Title or Position: OWNER
Credential:
Phone: 480-861-0306