Organization
LAMAC HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOYCE ODONGO REGISTERED NURSE (MANAGER/ADMINISTRATOR)
(647) 836-0887
Entity
Organization
Contact information
Practice address
4324 E FRIESS DR, PHOENIX, AZ 85032-5802
(647) 836-0887
Mailing address
4324 E FRIESS DR, PHOENIX, AZ 85032-5802
(647) 836-0887
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH3862
AZ
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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