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Organization
LEE LEGACY GROUP LLC
Active
Organization
LEE LEGACY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TREMEAL RAY MANLEY JR. (CHIEF EXECUTIVE OFFICER)
(480) 932-1804
Entity
Organization
Contact information
Practice address
1802 E VINEYARD RD, PHOENIX, AZ 85042-5704
(480) 932-1804
Mailing address
1802 E VINEYARD RD, PHOENIX, AZ 85042-5704
(480) 932-1804
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/28/2024
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