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Organization
TRI-PHASE GROUP HOME INC
Active
Organization
TRI-PHASE GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI MCKINNEY (DIRECTOR)
(623) 474-6326
Entity
Organization
Contact information
Practice address
1575 E BETSY LN UNIT D, GILBERT, AZ 85296-3759
(623) 474-6326
(623) 474-6516
Mailing address
18403 W VERDIN RD, GOODYEAR, AZ 85338-5081
(623) 474-6326
(623) 474-6516
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BH-1914
AZ
3245S0500X
Children's Substance Abuse Rehabilitation Facility
BH-1914
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
873770
AHCCCS
AZ
Enumeration date
02/28/2008
Last updated
06/26/2008
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