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Organization
THE PURPLE TRAIL CENTER LLC
Active
Organization
THE PURPLE TRAIL CENTER LLC
Active
Other names
PTC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMIKA DENISE HARROLD (OWNER)
(480) 518-4895
Entity
Organization
Contact information
Practice address
2601 W CLAREMONT ST APT 2070, PHOENIX, AZ 85017-6252
(480) 518-4895
Mailing address
2601 W CLAREMONT ST APT 2070, PHOENIX, AZ 85017-6252
(480) 518-4895
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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