NPI 1316237076

A Fresh Start and New Beginnings

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Glendale, AZ

Practice location

Address: 4105 W Villa Linda Dr, Glendale, AZ 85310-5157
Phone: (623) 434-2126
Fax: (623) 434-1494

Authorised official

Name: Beverly Bailey
Title: Ceo
Phone: (323) 379-6249

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence BH3871 (AZ)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Arizona →

Registry record

NPI: 1316237076
Entity type: Organization
NPI issued: 15 Apr 2011
Record last updated: 1 Jul 2011

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.