Assisted Living Concepts Inc
Organization Active NPI Assisted Living Facility · Payson, AZ
NPI 1245356708 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1245356708
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- ALC1999 (AZ)
- Legal business name
- ASSISTED LIVING CONCEPTS INC
- Practice address
- 806 West Longhorn Road
Payson, AZ 88541 - Phone
- (928) 474-6249
- Fax
- (520) 474-9764
- NPI assigned
- Mar 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Walter A Levonowich
- Title
- Vice President and Controller
- Phone
- (414) 908-8800
Corporate family (same tax ID) 8
National Provider Directory
- Tax ID family
- Assisted Living Concepts Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | ALC1999 | AZ | Yes |
Addresses
Primary practice location
806 West Longhorn Road
Payson, AZ 88541
Mailing address
111 W Michigan Street
9TH Floor
Milwaukee, WI 53203
Phone (414) 908-8800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 441907 | Medicaid | AZ |
Other names
- Powell House
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- Arizona Institute of Dermatology Payson LLC
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- Rachel Denise Armstrong
- Melissa Marie Avery
- Jessica L Balcom
- Matthew Balls
- Banner -- University Primary Care Physicians LLC
- Banner Cancer Center Specialists LLC
All providers in Payson, AZ · Assisted Living Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.