# TLR HOUSING PHOENIX LLC

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

## Provider details

- **NPI number:** 1962084137
- **Authorized official:** TONI L RICHARDSON (CEO)
- **Authorized official phone:** (773) 885-3945

## Contact information

- **Practice address:** 717 E PALMAIRE AVE, PHOENIX, AZ 85020-5359
- **Practice address phone:** (773) 885-3945
- **Mailing address:** 717 E PALMAIRE AVE, PHOENIX, AZ 85020-5359
- **Mailing address phone:** (773) 885-3945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 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