Organization
SHINING HEARTS RESIDENTIAL TREATMENT CENTER LLC
Active
Other names
Shining Hearts Residential Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
JADA ALEXANDER (PRESIDENT)
(469) 401-8195
Entity
Organization
Contact information
Practice address
21352 N DENTON DR, MARICOPA, AZ 85138-9559
(469) 401-8195
Mailing address
44920 W HATHAWAY AVE UNIT 658, MARICOPA, AZ 85139-9937
(469) 401-8195
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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