Organization
DESTINY BEHAVIORAL HEALTH RESIDENTIAL CARE LLC 5
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FUNSO FEYI OGUNLA (PROGRAM DIRECTOR)
(602) 384-8820
Entity
Organization
Contact information
Practice address
10313 W HESS STREET, TOLLESON, AZ 85353
(602) 384-8820
(623) 435-6566
Mailing address
2911 SOUTH 87TH DRIVE, TOLLESON, AZ 85353
(602) 384-8820
(623) 435-6566
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH5356
AZ
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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