# SHINING HEARTS RESIDENTIAL TREATMENT CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shining Hearts Residential Treatment Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205599016
- **Authorized official:** JADA ALEXANDER (PRESIDENT)
- **Authorized official phone:** (469) 401-8195

## Contact information

- **Practice address:** 21352 N DENTON DR, MARICOPA, AZ 85138-9559
- **Practice address phone:** (469) 401-8195
- **Mailing address:** 44920 W HATHAWAY AVE UNIT 658, MARICOPA, AZ 85139-9937
- **Mailing address phone:** (469) 401-8195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | — | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | — | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2021
- **Last updated:** 10/19/2021