Destiny Behavioral Health Residential Care Llc 3

NPI 1184012213 - Community Based Residential Treatment Facility, Mental Illness - 320800000X

NPI Details
NPI 1184012213
Enumeration Date 12/23/2014
Last Updated 12/23/2014
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name FUNSO FEYI FUNSO
Position PROGRAM DIRECTOR
Phone (623) 748-3636
Fax (623) 435-6566
Practice Location
3427 S 84TH LN
TOLLESON AZ, 85353-7610, US
Phone (623) 748-3636
Fax (623) 435-6566
Business Location
2911 S 87TH DR
TOLLESON AZ, 85353-8650, US
Phone (623) 435-6566
Fax (623) 435-6566
Toxanomy
Taxonomy Code 320800000X
License State Arizona
License Number BH4528
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According to our database, Destiny Behavioral Health Residential Care Llc 3 NPI is 1184012213, taxonomy code is 320800000X and license number is BH4528, license state is located at Arizona. Destiny Behavioral Health Residential Care Llc 3 physically located at 3427 S 84th Ln, Tolleson AZ, 85353-7610. NPI Number 1033115704 has the healthcare provider type.

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1184012213 NPI number is provided on an as is basis without warranty of any kind. 1184012213 is maintained by the National Plan & Provider Enumeration System. The contents of Destiny Behavioral Health Residential Care Llc 3 are for informational purposes only.