Organization
TWIN HEARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE VANDYCK (MANAGER)
(224) 595-0110
Entity
Organization
Contact information
Practice address
15223 W TAYLOR ST, GOODYEAR, AZ 85338-4115
(224) 595-0112
Mailing address
15223 W TAYLOR ST, GOODYEAR, AZ 85338-4115
(224) 595-0112
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/21/2022
Last updated
05/21/2022
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