Provider Demographics
NPI:1427358670
Name:ASSISTED LIVING & CARE, INC.
Entity Type:Organization
Organization Name:ASSISTED LIVING & CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS-STUBER
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:602-809-4810
Mailing Address - Street 1:4840 E DOWNING CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6449
Mailing Address - Country:US
Mailing Address - Phone:602-809-4810
Mailing Address - Fax:
Practice Address - Street 1:4840 E DOWNING CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-6449
Practice Address - Country:US
Practice Address - Phone:602-809-4810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL8190H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility