Organization
DENALI YOUTH HOMES OF ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY TYSON (CEO)
(907) 301-0333
Entity
Organization
Contact information
Practice address
5747 W WARNER ST, PHOENIX, AZ 85043-6432
(907) 301-0333
Mailing address
5747 W WARNER ST, PHOENIX, AZ 85043-6432
(907) 301-0333
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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