Organization
VICIT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC MACHARIA (ADMINISTRATOR)
(858) 603-8388
Entity
Organization
Contact information
Practice address
4430 W ST KATERI DR, LAVEEN, AZ 85339-6238
(858) 603-8388
(602) 916-1467
Mailing address
4630 W FREMONT RD, LAVEEN, AZ 85339-4277
(858) 603-8388
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
02/01/2022
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