Provider Demographics
NPI:1417330929
Name:BEAUTIFUL BEGINNINGS ASSISTED LIVING HOME LLC
Entity Type:Organization
Organization Name:BEAUTIFUL BEGINNINGS ASSISTED LIVING HOME LLC
Other - Org Name:BEAUTIFUL BEGINNINGS RESIDENTIAL HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-418-8313
Mailing Address - Street 1:2819 S 73RD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-7255
Mailing Address - Country:US
Mailing Address - Phone:623-418-8313
Mailing Address - Fax:623-322-9255
Practice Address - Street 1:2819 S 73RD DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-7255
Practice Address - Country:US
Practice Address - Phone:623-418-8313
Practice Address - Fax:623-322-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH5072320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness