NPI 1013558311

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Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Phoenix, AZ

Practice location

Address: 6420 W Cocopah St, Phoenix, AZ 85043
Phone: (602) 999-2400
Fax: (623) 444-7829
Mailing address: PO Box 8237, Phoenix, AZ 85066-8237

Authorised official

Name: Gracie Gonzalez Padilla
Title: Chief Executive Officer
Phone: (623) 518-9552

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Arizona →

Registry record

NPI: 1013558311
Entity type: Organization
NPI issued: 8 Oct 2019
Record last updated: 8 Oct 2019

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.