Organization
INTEGRATED LEGACY SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASHID MATEEN (OWNER)
(480) 516-6081
Entity
Organization
Contact information
Practice address
15526 W RIO VISTA LN, GOODYEAR, AZ 85338-9441
(480) 516-6081
Mailing address
PO BOX 67472, PHOENIX, AZ 85082-7472
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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