Healthcare Provider Details

I. General information

NPI: 1083259907
Provider Name (Legal Business Name): SCOTTSDALE QUARTER ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6321 E EVANS DR
SCOTTSDALE AZ
85254-3219
US

IV. Provider business mailing address

10750 W WINDSOR AVE
AVONDALE AZ
85392-5830
US

V. Phone/Fax

Practice location:
  • Phone: 623-687-4122
  • Fax: 480-687-4134
Mailing address:
  • Phone: 623-687-4122
  • Fax: 480-687-4135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE A ARANETA
Title or Position: OWNER
Credential:
Phone: 623-687-4122