Organization · NPI-2

Advanced Supported Living Services, LLC

Day Training, Developmentally Disabled Services · Peoria, AZ

NPI number1922451665

StatusActive

Last updated in NPPESJul 18, 2016

Details

NPI: 1922451665
Entity type: Organization (NPI-2)
Legal business name: Advanced Supported Living Services, LLC
Organization subpart: No
Enumeration date: Jul 18, 2016
Last updated: Jul 18, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251C00000X	Day Training, Developmentally Disabled Services	–	–	Yes
253Z00000X	In Home Supportive Care	–	–

Practice location

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

Phone 480-548-7446 · Fax 480-907-1744

Mailing address

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

Phone 480-548-7446 · Fax 480-907-1744

Authorized official

Michael James Churchill
Chief Executive Officer
4805487446

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