Healthcare Provider Details

I. General information

NPI: 1932062999
Provider Name (Legal Business Name): PRIME ASSISTANT LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 BURR OAK LN
MADISON WI
53713-1228
US

IV. Provider business mailing address

826 BURR OAK LN
MADISON WI
53713-1228
US

V. Phone/Fax

Practice location:
  • Phone: 608-515-7400
  • Fax:
Mailing address:
  • Phone: 608-515-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: RASHID ALI MURSAL
Title or Position: OWNER
Credential:
Phone: 608-515-7400