Advanced Supported Living Services, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

ADVANCED SUPPORTED LIVING SERVICES, LLC

Practice address

20403 N Lake Pleasant Rd
Suite 117-232
Peoria, AZ 85382-9702

Phone

(480) 548-7446

Fax

(480) 907-1744

NPI assigned

Jul 18, 2016

Organization subpart

No

Name

Michael James Churchill, RN

Title

Chief Executive Officer

Phone

(480) 548-7446

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 18, 2016.

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1922451665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20403 N LAKE PLEASANT RD",
            "address_2": "SUITE 117-232",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829702",
            "telephone_number": "480-548-7446",
            "fax_number": "480-907-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20403 N LAKE PLEASANT RD",
            "address_2": "SUITE 117-232",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829702",
            "telephone_number": "480-548-7446",
            "fax_number": "480-907-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SUPPORTED LIVING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "CHURCHILL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "480-548-7446",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adio Az Inc
• Clarence S Adoo, M.D.
• Adult Geriatric Care Group
• Advanced Air Amulance LLC
• Advanced Diagnostics Network Inc.
• Advanced Training Consultants LLC
• Advent LLC
• Aegis Medical Care of Az, PC
• Afc of Peoria, PLLC
• Afc of Peoria, PLLC

• All providers in Peoria, AZ
• Developmentally Disabled Services Day Training Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.