Provider Demographics
NPI:1194533810
Name:ARISEVIDA CARE LLC
Entity type:Organization
Organization Name:ARISEVIDA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-796-3484
Mailing Address - Street 1:4040 E MCDOWELL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4428
Mailing Address - Country:US
Mailing Address - Phone:602-899-1229
Mailing Address - Fax:
Practice Address - Street 1:4040 E MCDOWELL RD STE 107
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4428
Practice Address - Country:US
Practice Address - Phone:602-899-1229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty