Provider Demographics
NPI:1083259907
Name:SCOTTSDALE QUARTER ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:SCOTTSDALE QUARTER ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARANETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-687-4122
Mailing Address - Street 1:10750 W WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5830
Mailing Address - Country:US
Mailing Address - Phone:623-687-4122
Mailing Address - Fax:480-687-4135
Practice Address - Street 1:6321 E EVANS DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3219
Practice Address - Country:US
Practice Address - Phone:623-687-4122
Practice Address - Fax:480-687-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health