Organization
GREYSTONE HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX RAUL PESCADOR (ADMINISTRATOR)
(602) 525-5468
Entity
Organization
Contact information
Practice address
25816 N FERNBUSH DR, PHOENIX, AZ 85083-1615
(602) 525-5468
(602) 467-3153
Mailing address
25816 N FERNBUSH DR, PHOENIX, AZ 85083-1615
(602) 525-5468
(602) 467-3153
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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