| Phoenix Residential Behavioral Health Llc | |
|
3555 N Sailboat Ln Avondale AZ 85392-3620 | |
| (480) 977-9457 | |
| Not Available |
| Full Name | Phoenix Residential Behavioral Health Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3555 N Sailboat Ln, Avondale, Arizona |
| Authorized Official Name and Position | Usman Jawa Bundu (DIRECTOR) |
| Authorized Official Contact | 1480977945 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Residential Behavioral Health Llc 3555 N Sailboat Ln Avondale AZ 85392-3620 Ph: (480) 977-9457 | Phoenix Residential Behavioral Health Llc 3555 N Sailboat Ln Avondale AZ 85392-3620 Ph: (480) 977-9457 |
| NPI Number | 1669244760 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669244760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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