Provider Demographics
NPI:1841403672
Name:ASSISTED LIVING SERVICES INC
Entity Type:Organization
Organization Name:ASSISTED LIVING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAQUILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-634-8668
Mailing Address - Street 1:290 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2564
Mailing Address - Country:US
Mailing Address - Phone:203-634-8668
Mailing Address - Fax:203-238-2569
Practice Address - Street 1:290 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2564
Practice Address - Country:US
Practice Address - Phone:203-634-8668
Practice Address - Fax:203-238-2569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
CTHCA0000124376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty