Provider Demographics
NPI:1609947845
Name:GOOD NEIGHBOR ASSISTED LIVING SERVICES INC
Entity Type:Organization
Organization Name:GOOD NEIGHBOR ASSISTED LIVING SERVICES INC
Other - Org Name:GOOD NEIGHBOR SUPPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:P
Authorized Official - Last Name:DE MARAH
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:623-932-4878
Mailing Address - Street 1:15655 W ROOSEVELT PKWY
Mailing Address - Street 2:SUITE 213
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9282
Mailing Address - Country:US
Mailing Address - Phone:623-932-4878
Mailing Address - Fax:623-850-9985
Practice Address - Street 1:15655 W ROOSEVELT PKWY
Practice Address - Street 2:SUITE 213
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-9282
Practice Address - Country:US
Practice Address - Phone:623-932-4878
Practice Address - Fax:623-850-9985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health