Healthcare Provider Details

I. General information

NPI: 1437299880
Provider Name (Legal Business Name): ADULT RESIDENTIAL CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

878 SUNSET AVE
PRESCOTT AZ
86305-1824
US

IV. Provider business mailing address

844 SUNSET AVE
PRESCOTT AZ
86305-1824
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-6633
  • Fax:
Mailing address:
  • Phone: 928-771-2335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License NumberALC-2168
License Number StateAZ

VIII. Authorized Official

Name: MR. MIKE SHOWERS
Title or Position: CFO
Credential:
Phone: 928-771-2335