Organization
STARLIGHT WELLNESS LLC
Active
Other names
Starlight Wellness LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINE MIYA (OWNER)
(602) 820-4104
Entity
Organization
Contact information
Practice address
9196 W MINE TRL, PEORIA, AZ 85383-5129
(602) 820-4104
Mailing address
9196 W MINE TRL, PEORIA, AZ 85383-5129
(602) 820-4104
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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