Provider Demographics
NPI:1245092766
Name:LIVING HOPE ARCADIA LLC
Entity type:Organization
Organization Name:LIVING HOPE ARCADIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-409-4952
Mailing Address - Street 1:8140 W GIBSON LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-7487
Mailing Address - Country:US
Mailing Address - Phone:207-409-4952
Mailing Address - Fax:
Practice Address - Street 1:8140 W GIBSON LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-7487
Practice Address - Country:US
Practice Address - Phone:207-409-4952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness