| Pha Residential Llc | |
|
5312 W Stargazer Pl Laveen AZ 85339-4512 | |
| (602) 502-6238 | |
| Not Available |
| Full Name | Pha Residential Llc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 5312 W Stargazer Pl, Laveen, Arizona |
| Authorized Official Name and Position | Phalina Mitchell (OWNER) |
| Authorized Official Contact | 6025026238 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pha Residential Llc 5312 W Stargazer Pl Laveen AZ 85339-4512 Ph: (602) 502-6238 | Pha Residential Llc 5312 W Stargazer Pl Laveen AZ 85339-4512 Ph: (602) 502-6238 |
| NPI Number | 1396597753 |
|---|---|
| Provider Enumeration Date | 04/01/2024 |
| Last Update Date | 04/02/2024 |
| Certification Date | 04/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396597753 | NPI | - | NPPES |
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