| Destiny Sober Living | |
|
5306 N 17th Ave Phoenix AZ 85015-3035 | |
| (602) 249-6674 | |
| (602) 926-0590 |
| Full Name | Destiny Sober Living |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 5306 N 17th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Kathleen Bynum (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6022496674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Sober Living 5306 N 17th Ave Phoenix AZ 85015-3035 Ph: (602) 249-6674 | Destiny Sober Living 5306 N 17th Ave Phoenix AZ 85015-3035 Ph: (602) 249-6674 |
| NPI Number | 1104365287 |
|---|---|
| Provider Enumeration Date | 02/22/2017 |
| Last Update Date | 02/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104365287 | NPI | - | NPPES |
| 439095 | Medicaid | AZ | |
| 148801 | Medicaid | AZ | |
| 925164 | Medicaid | AZ |
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