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General NPI Number Information
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NPI Number | 1457072621
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Entity Type | Organization
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Legal Business Name | ASSISSTED LOVING HOMECARE LLC
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 18993 W READE AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5786
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Country | US
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Telephone | 414-526-2906
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 N EL MIRAGE DR
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City | AVONDALE
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State | AZ
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Zip | 85392-3843
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Country | US
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Telephone | 414-366-5380
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TINA TOOMBS
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Credential |
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Telephone | 414-366-5380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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