NPI 1013177666

The 12th Ave House #1

Organisation Mental Illness Community Based Residential Treatment Facility Phoenix, AZ

Practice location

Address: 9606 N 12th Ave, Phoenix, AZ 85021-3095
Phone: (602) 441-2691

Authorised official

Name: Elizabeth Singleton
Title: Administrator
Phone: (602) 441-2691

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence BH - 3055 (AZ)

Other Community Based Residential Treatment Facility, Mental Illness providers in Arizona →

Registry record

NPI: 1013177666
Entity type: Organization
NPI issued: 16 Jun 2008
Record last updated: 16 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.