Organization
SCOTT GROUP 010 LLC
Active
Other names
Heroic Housing
Organization subpart
No
Provider details
NPI number
Authorized official
GARY A SCOTT SR. (CEO)
(703) 864-8197
Entity
Organization
Contact information
Practice address
6551 S 43RD LN, LAVEEN, AZ 85339-6246
(480) 613-7677
Mailing address
15411 W WADDELL RD STE 102-128, SURPRISE, AZ 85379-5170
(480) 613-7677
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
12/10/2024
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