Organization
THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC
Active
Other names
The River Source Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
TINA LEE (FINANCE DIRECTOR)
(520) 582-4718
Entity
Organization
Contact information
Practice address
16286 S. SUNLAND GIN RD, STE B, ARIZONA CITY, AZ 85123-8512
(866) 367-8069
(520) 413-5944
Mailing address
PO BOX 4293, ARIZONA CITY, AZ 85123-2669
(480) 298-7301
(520) 413-5944
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
544985
—
AZ
Enumeration date
01/05/2023
Last updated
01/05/2023
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