Organization
OPTIMUM CARE OF ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FAIRLEY JR. (OWNER)
(702) 665-0228
Entity
Organization
Contact information
Practice address
717 E HARWELL RD, PHOENIX, AZ 85042-6655
(702) 665-0228
Mailing address
717 E HARWELL RD, PHOENIX, AZ 85042-6655
(702) 665-0228
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/02/2020
Last updated
04/02/2020
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