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Organization
THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC
Active
Organization
THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA VALENCIA (BILLING AND CLAIMS MANAGER)
(480) 298-7301
Entity
Organization
Contact information
Practice address
7910 W THOMAS RD STE 103, PHOENIX, AZ 85033-4837
(480) 298-7301
(520) 413-5944
Mailing address
PO BOX 4293, ARIZONA CITY, AZ 85123-2669
(480) 298-7301
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
—
NULL
2084P0802X
Addiction Psychiatry Physician
Primary
—
—
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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