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Organization

HARD ROCK RECOVERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHEL KANYAMBO (CHIEF EXECUTIVE OFFICER)
(207) 415-5393
Entity
Organization

Contact information

Practice address
1616 E INDIAN SCHOOL ROAD SUITE 415, PHOENIX, AZ 85016
(207) 415-5393
Mailing address
1616 E INDIAN SCHOOL ROAD 415, PHOENIX, AZ 85016
(207) 415-5393

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
05/08/2023
Last updated
05/08/2023
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