NPI 1770038564

South Mountain Holistic Care

Organisation Mental Illness Intermediate Care Facility Laveen, AZ

Practice location

Address: 3219 W Olney Ave, Laveen, AZ 85339-1783
Phone: (602) 565-5909
Mailing address: 3219 W Olney Ave, Laveen, AZ 85339

Authorised official

Name: Stephanie Lynn Brigham
Title: Executive Director
Phone: (602) 565-5909

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X Licence BH4914 (AZ)

Other Intermediate Care Facility, Mental Illness providers in Arizona →

Registry record

NPI: 1770038564
Entity type: Organization
NPI issued: 22 Aug 2016
Record last updated: 22 Aug 2016

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.