NPIMap

Organization Active NPI

Live Well Assisted Living

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1811527047
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
LIVE WELL ASSISTED LIVING
Practice address
6462 S 4TH St
Phoenix, AZ 85042-7604
Phone
(623) 399-7824
Fax
(855) 538-5652
NPI assigned
Jan 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Desire Rusingizwa, BHT
Title
Program Director
Phone
(623) 877-3764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

6462 S 4TH St
Phoenix, AZ 85042-7604

Mailing address

6462 S 4TH St
Phoenix, AZ 85042-7604
Phone (623) 399-7824

Other names 1

  • LIVE WELL RESIDENTIAL CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Live Well Assisted Living LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1811527047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6462 S 4TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850427604",
            "telephone_number": "623-399-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6462 S 4TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850427604",
            "telephone_number": "623-399-7824",
            "fax_number": "855-538-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "RUSINGIZWA",
        "authorized_official_first_name": "DESIRE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "623-877-3764",
        "authorized_official_credential": "BHT"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVE WELL RESIDENTIAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.