Organization
TRI-PHASE GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI MCKINNEY (OWNER/DIRECTOR)
(623) 474-6326
Entity
Organization
Contact information
Practice address
2355 E ELMWOOD ST, MESA, AZ 85213-5909
(623) 474-6326
(623) 474-6516
Mailing address
18403 W VERDIN RD, GOODYEAR, AZ 85338-5081
(623) 474-6326
(623) 474-6516
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
BH-2891
AZ
Other
Enumeration date
04/02/2008
Last updated
06/26/2008
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