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Organization
SHALOM TREATMENT CENTER LLC
Active
Organization
SHALOM TREATMENT CENTER LLC
Active
Other names
Shalom Treatment Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SCOVIA BASALIZA (CHIEF EXECUTIVE OFFICER)
(240) 559-7617
Entity
Organization
Contact information
Practice address
3844 N 24TH ST, PHOENIX, AZ 85016-6513
(240) 559-7617
Mailing address
3844 N 24TH ST, PHOENIX, AZ 85016-6513
(240) 559-7617
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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