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Organization
HOME AWAY FROM HOME BEHAVIORAL HEALTH RESIDENTIAL FACILITY INC.
Active
Organization
HOME AWAY FROM HOME BEHAVIORAL HEALTH RESIDENTIAL FACILITY INC.
Active
Other names
Home Away From Home Behavioral Health Residential
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA MARGUERITE AYIYI LPN (CEO)
(602) 559-6033
Entity
Organization
Contact information
Practice address
9231 W MOUNTAIN VIEW RD, PEORIA, AZ 85345-4306
(602) 559-6033
(623) 322-8622
Mailing address
PO BOX 7077, GOODYEAR, AZ 85338-0635
(602) 559-6033
(623) 322-8622
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH4584
AZ
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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