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Organization
TLR HOUSING PHOENIX LLC
Active
Organization
TLR HOUSING PHOENIX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI L RICHARDSON (CEO)
(773) 885-3945
Entity
Organization
Contact information
Practice address
717 E PALMAIRE AVE, PHOENIX, AZ 85020-5359
(773) 885-3945
Mailing address
717 E PALMAIRE AVE, PHOENIX, AZ 85020-5359
(773) 885-3945
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
320700000X
Physical Disabilities Residential Treatment Facility
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
NULL
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
NULL
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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