# AZ LAVENDER BEHAVIORAL HEALTH SERVICES LLC

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

## Provider details

- **NPI number:** 1578209920
- **Authorized official:** MISS ZUHAL FADL (ADMINISTRATOR)
- **Authorized official phone:** (602) 581-1588

## Contact information

- **Practice address:** 3428 N 47TH AVE, PHOENIX, AZ 85031-3101
- **Practice address phone:** (602) 581-1588
- **Practice address fax:** (623) 302-7174
- **Mailing address:** 3428 N 47TH AVE, PHOENIX, AZ 85031-3101
- **Mailing address phone:** (602) 581-1588
- **Mailing address fax:** (623) 302-7174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/09/2022
- **Last updated:** 05/09/2022