Organization
ALPINE VILLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC GLADE MAUGHAN (ADMINISTRATOR)
(602) 292-2010
Entity
Organization
Contact information
Practice address
14414 N 29TH ST, PHOENIX, AZ 85032-5004
(602) 292-2010
Mailing address
6439 W WILLOW AVE, GLENDALE, AZ 85304-1050
(602) 292-2010
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/22/2020
Last updated
01/16/2024
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