Organization
THE 12TH AVE HOUSE #1
Active
Other names
Helping Hearts #1
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SINGLETON (ADMINISTRATOR)
(602) 441-2691
Entity
Organization
Contact information
Practice address
9606 N 12TH AVE, PHOENIX, AZ 85021-3095
(602) 441-2691
Mailing address
9606 N 12TH AVE, PHOENIX, AZ 85021-3095
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH - 3055
AZ
Other
Enumeration date
06/16/2008
Last updated
06/16/2008
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