Organization
HARMONY PROVIDER CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC PAIGE (CHIEF ADMINISTRATIVE OFFICER)
(480) 395-0233
Entity
Organization
Contact information
Practice address
10428 W CHICKASAW ST, TOLLESON, AZ 85353-1387
(480) 395-0233
Mailing address
15823 N 57TH ST, SCOTTSDALE, AZ 85254-6204
(480) 395-0233
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
04/15/2022
Last updated
04/15/2022
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