Organization
LEE LEGACY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TREMEAL RAY MANLEY JR. (CHIEF EXECUTIVE OFFICER)
(480) 932-1804
Entity
Organization
Contact information
Practice address
1802 E VINEYARD RD, PHOENIX, AZ 85042-5704
(480) 932-1804
Mailing address
1802 E VINEYARD RD, PHOENIX, AZ 85042-5704
(480) 932-1804
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/28/2024
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