Organization
PHOENIX RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZINA GRAY (AGENCY ADMINISTRATION)
(480) 939-0826
Entity
Organization
Contact information
Practice address
3101 W LARKSPUR DR, PHOENIX, AZ 85029-2331
(480) 939-0826
(602) 518-6894
Mailing address
3101 W LARKSPUR DR, PHOENIX, AZ 85029-2331
(480) 939-0826
(602) 518-6894
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH5032
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103TM1800X
BEHAVIORAL HEALTH RESIDENTIAL
AZ
Enumeration date
12/10/2016
Last updated
12/10/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us