Provider Demographics
NPI:1558159954
Name:LIVE TRUE ASSISTED LIVING SCOTTSDALE
Entity type:Organization
Organization Name:LIVE TRUE ASSISTED LIVING SCOTTSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRAXTON
Authorized Official - Middle Name:
Authorized Official - Last Name:FENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-718-5001
Mailing Address - Street 1:13614 N 89TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-7653
Mailing Address - Country:US
Mailing Address - Phone:510-303-7952
Mailing Address - Fax:
Practice Address - Street 1:13614 N 89TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7653
Practice Address - Country:US
Practice Address - Phone:510-303-7952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility