Provider Demographics
NPI:1023658127
Name:CAREFREE MANOR ASSISTED LIVING LLC
Entity type:Organization
Organization Name:CAREFREE MANOR ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIMISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:ANGELINA
Authorized Official - Last Name:CARRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:623-698-2322
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-0910
Mailing Address - Country:US
Mailing Address - Phone:623-698-2322
Mailing Address - Fax:480-595-3175
Practice Address - Street 1:7886 E BREATHLESS DR
Practice Address - Street 2:
Practice Address - City:CAREFREE
Practice Address - State:AZ
Practice Address - Zip Code:85377
Practice Address - Country:US
Practice Address - Phone:623-698-2322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities