Organization
BRILLIANT MIND WELLNESS LLC
Active
Other names
FOREVER HOME
Organization subpart
No
Provider details
NPI number
Authorized official
ULYSSES LAURENTE (ADMINISTRATOR)
(623) 565-3555
Entity
Organization
Contact information
Practice address
149 E JOAN D ARC AVE, PHOENIX, AZ 85022-4704
(623) 565-3555
Mailing address
13384 W RIMROCK ST, SURPRISE, AZ 85374-5211
(623) 565-3555
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
03/31/2026
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