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Living 365 LLC

Community Based Residential Treatment Facility, Mental Illness in Goodyear, AZ. Organization (NPI-2).

NPI number1962052266
StatusActive
Last updated in NPPESDec 16, 2019

Details

NPI
1962052266
Entity type
Organization (NPI-2)
Legal business name
Living 365 LLC
Organization subpart
No
Enumeration date
Sep 18, 2019
Certification date
Dec 16, 2019
Last updated
Dec 16, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320800000X Community Based Residential Treatment Facility, Mental Illness––Yes
323P00000X Psychiatric Residential Treatment Facility––
163WP0809X Registered Nurse, Psych/Mental Health, Adult––
174200000X Meals––
177F00000X Lodging––
251J00000X Nursing Care––

Practice location

2267 S 173rd Dr
Goodyear, AZ 85338-1961

Phone 623-248-4342 · Fax 623-248-6096

Mailing address

11250 E Quicksilver Ave
Mesa, AZ 85212-4005

Phone 803-600-6939

Authorized official

Angela Muhammad
Owner
6232484342

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Mental Illness Community Based Residential Treatment Facility providers in Goodyear, AZ

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