Organization
BONITA PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIANNA CANN (ADMINISTRATOR)
(520) 840-3182
Entity
Organization
Contact information
Practice address
1189 E BONITA PL, CASA GRANDE, AZ 85122-2906
(520) 233-7679
Mailing address
1977 N LEWIS PL, CASA GRANDE, AZ 85122-6188
(520) 840-3182
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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