| The River Source Treatment Center Casa Grande, Llc | |
|
16286 S Sunland Gin Rd Arizona City AZ 85123-6196 | |
| (888) 687-7332 | |
| Not Available |
| Full Name | The River Source Treatment Center Casa Grande, Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 16286 S Sunland Gin Rd, Arizona City, Arizona |
| Authorized Official Name and Position | Tina Lee (FINANCE DIRECTOR) |
| Authorized Official Contact | 5205824718 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The River Source Treatment Center Casa Grande, Llc Po Box 4293 Arizona City AZ 85123-2669 Ph: (888) 687-7332 | The River Source Treatment Center Casa Grande, Llc 16286 S Sunland Gin Rd Arizona City AZ 85123-6196 Ph: (888) 687-7332 |
| NPI Number | 1003053570 |
|---|---|
| Provider Enumeration Date | 01/20/2009 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003053570 | NPI | - | NPPES |
| 496790 | Other | JOINT COMMISSION | |
| IFB6615 | Other | AZ | AZDHS |
| OTC9325 | Other | AZ | AZDHS - GILBERT LOCATION |
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