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Organization

REBIRTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE JONES BHT (ADM)
(602) 731-5188
Entity
Organization

Contact information

Practice address
5008 W GLENDALE AVE STE 110, GLENDALE, AZ 85301-2751
(602) 731-5188
Mailing address
9023 W HUBBELL ST, PHOENIX, AZ 85037-3882
(602) 731-5188

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
103TP2701X
Group Psychotherapy Psychologist
106S00000X
Behavior Technician

Other

Enumeration date
06/29/2023
Last updated
06/29/2023
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