Organization
SHALOM TREATMENT CENTER LLC
Active
Other names
Shalom Treatment Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SCOVIA BASALIZA (CHIEF EXECUTIVE OFFICER)
(240) 559-7617
Entity
Organization
Contact information
Practice address
3844 N 24TH ST, PHOENIX, AZ 85016-6513
(240) 559-7617
Mailing address
3844 N 24TH ST, PHOENIX, AZ 85016-6513
(240) 559-7617
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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