Organization
HOA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICK TYMINSKI (OWNER)
(602) 756-3027
Entity
Organization
Contact information
Practice address
12538 W SIERRA ST, EL MIRAGE, AZ 85335-5278
(602) 756-3027
Mailing address
12538 W SIERRA ST, EL MIRAGE, AZ 85335-5278
(602) 756-3027
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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