NPI 1629198858

Active Assisted Living, LLC

Organisation Physical Disabilities Residential Treatment Facility Mesa, AZ

Practice location

Address: 758 S Toltec, Mesa, AZ 85204-3642
Phone: (480) 461-8272
Fax: (480) 461-4682
Mailing address: 1235 S Gilbert Rd STE 3, Pmb 83, Mesa, AZ 85204-6005

Authorised official

Name: Steven James Tharalson
Title: Director
Phone: (480) 461-8272

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence ALH-4567 (AZ)

Other Residential Treatment Facility, Physical Disabilities providers in Arizona →

Registry record

NPI: 1629198858
Entity type: Organization
NPI issued: 30 Mar 2007
Record last updated: 1 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.