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Organization
SHALOM BEHAVIORAL CARE LLC
Active
Organization
SHALOM BEHAVIORAL CARE LLC
Active
Parent organization
SHALOM BEHAVIORAL CARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHALOM BEHAVIORAL CARE, LLC
Authorized official
ANTHONY VINCENT OLORUNSOLA (STATUTORY OFFICER)
(623) 806-6864
Entity
Organization
Contact information
Practice address
10612 E MARIGOLD LN, FLORENCE, AZ 85132-7320
(480) 684-2004
(480) 582-6043
Mailing address
10612 E MARIGOLD LN, FLORENCE, AZ 85132-7320
(480) 684-2004
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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