# FAY'S HOUSE 1,2,3 LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467666131
- **Authorized official:** MRS. DEE'ANNA MARIE MCQUILLER (CHIEF ADMINISTRATOR)
- **Authorized official phone:** (602) 304-0316

## Contact information

- **Practice address:** 408 W BEVERLY RD, PHOENIX, AZ 85041-8111
- **Practice address phone:** (602) 304-0316
- **Practice address fax:** (602) 276-0138
- **Mailing address:** 408 W BEVERLY RD, PHOENIX, AZ 85041-8111
- **Mailing address phone:** (602) 304-0316
- **Mailing address fax:** (602) 276-0138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | BH 2693 | AZ | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 01/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 146283 | — | AZ |