Organization
A FRESH START AND NEW BEGINNINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY BAILEY (CEO)
(323) 379-6249
Entity
Organization
Contact information
Practice address
4105 W VILLA LINDA DR, GLENDALE, AZ 85310-5157
(623) 434-2126
(623) 434-1494
Mailing address
4105 W VILLA LINDA DR, GLENDALE, AZ 85310-5157
(623) 434-2126
(623) 434-1494
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
BH3871
AZ
Other
Enumeration date
04/15/2011
Last updated
07/01/2011
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