Organization
GRACE OF SERENITY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY R MEADE (CEO)
(602) 441-4690
Entity
Organization
Contact information
Practice address
6620 S 26TH DR, PHOENIX, AZ 85041-5366
(602) 441-4690
Mailing address
2720 E THOMAS RD STE 200B, PHOENIX, AZ 85016-8242
(602) 441-4690
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH2942
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
911695
AHCCS
AZ
Enumeration date
03/07/2008
Last updated
03/07/2008
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