NPI 1093223125

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Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Phoenix, AZ

Practice location

Address: 3301 N 63rd Ave, Phoenix, AZ 85033-5203
Phone: (623) 249-4448
Fax: (623) 444-7829
Mailing address: PO Box 8237, Phoenix, AZ 85066-8237

Authorised official

Name: Gracie Gonzalez Padilla
Title: Chief Executive Officer
Phone: (602) 999-2400

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence BH-5346 (AZ)

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

Registry record

NPI: 1093223125
Entity type: Organization
NPI issued: 10 Jan 2018
Record last updated: 18 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.