Healthcare Provider Details

I. General information

NPI: 1881847671
Provider Name (Legal Business Name): BFB ASSISTED LIVING HOMES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W FIR ST
COTTONWOOD AZ
86326-4762
US

IV. Provider business mailing address

1001 S 10TH ST
COTTONWOOD AZ
86326-4428
US

V. Phone/Fax

Practice location:
  • Phone: 928-649-1351
  • Fax: 928-649-1383
Mailing address:
  • Phone: 928-634-7198
  • Fax: 928-634-1635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALH-6705
License Number StateAZ

VIII. Authorized Official

Name: MRS. LORI MARIE FRUCHEY
Title or Position: OWNER, MANGER
Credential:
Phone: 928-634-7198