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General NPI Number Information
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NPI Number | 1790320810
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Entity Type | Organization
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Legal Business Name | LIVE AGAIN AZ LLC
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 6630 E LINCOLN DR
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-4331
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Country | US
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Telephone | 602-909-8442
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Fax |
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Provider Business Mailing Address
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Address Line | 9448 E HIDDEN SPUR TRL
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-6070
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Country | US
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Telephone | 602-909-8442
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ROBERT ADAMO
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Credential |
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Telephone | 602-909-8442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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