Provider Demographics
NPI:1790320810
Name:LIVE AGAIN AZ LLC
Entity Type:Organization
Organization Name:LIVE AGAIN AZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-909-8442
Mailing Address - Street 1:9448 E HIDDEN SPUR TRL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6070
Mailing Address - Country:US
Mailing Address - Phone:602-909-8442
Mailing Address - Fax:
Practice Address - Street 1:6630 E LINCOLN DR
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-4331
Practice Address - Country:US
Practice Address - Phone:602-909-8442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility