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Organization

THOMPSON HOUSE FOR YOUTH LEADERSHIP AND WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TYREE THOMPSON (OWNER)
(602) 618-5369
Entity
Organization

Contact information

Practice address
6536 N 28TH GLN, PHOENIX, AZ 85017-1282
(602) 841-0423
Mailing address
6536 N 28TH GLN, PHOENIX, AZ 85017

Taxonomy

Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
BH-3419
AZ

Other

Enumeration date
03/04/2010
Last updated
03/04/2010
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