Organization
SPRINGBROOK HABILITATION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE W GREEN JR. M.ED. (CLINICAL DIRECTOR)
(602) 424-1838
Entity
Organization
Contact information
Practice address
3843 E LARKSPUR DR, PHOENIX, AZ 85032-7345
(602) 595-3025
(602) 595-6029
Mailing address
4835 E CACTUS RD, SUITE # 460, SCOTTSDALE, AZ 85254-4191
(602) 424-1838
(602) 424-7879
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-2586
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701418
—
AZ
Enumeration date
03/19/2008
Last updated
12/28/2009
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