Organization
RESILIENT ROOTS RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA DE ALVA (CEO)
(520) 861-6857
Entity
Organization
Contact information
Practice address
10630 E CORBIN AVE, MESA, AZ 85212-9490
(520) 861-6857
Mailing address
10630 E CORBIN AVE, MESA, AZ 85212-9490
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/03/2024
Last updated
08/03/2024
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