Organization
ARCHAIC LIFESTYLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRIECE SESSION (AUTHORIZED AGENT)
(562) 506-3974
Entity
Organization
Contact information
Practice address
41768 W BARCELONA DR, MARICOPA, AZ 85138-4445
(562) 506-3974
Mailing address
41768 W BARCELONA DR, MARICOPA, AZ 85138-4445
(562) 506-3974
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
08/26/2023
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