Provider Demographics
NPI:1457828279
Name:NORTH VALLEY ASSISTED LIVING L.L.C
Entity Type:Organization
Organization Name:NORTH VALLEY ASSISTED LIVING L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CODRUTA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:SAV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-410-0501
Mailing Address - Street 1:2410 W DESPERADO WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-5778
Mailing Address - Country:US
Mailing Address - Phone:602-410-0501
Mailing Address - Fax:623-580-9091
Practice Address - Street 1:2410 W DESPERADO WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-5778
Practice Address - Country:US
Practice Address - Phone:602-410-0501
Practice Address - Fax:623-580-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility