Organization
SUN STATE BEHAVIORAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MABANY (CHIEF EXECUTIVE OFFICER)
(602) 384-0669
Entity
Organization
Contact information
Practice address
9525 W MINNEZONA AVE, PHOENIX, AZ 85037-1349
(623) 872-5454
Mailing address
9525 W MINNEZONA AVE, PHOENIX, AZ 85037-1349
(623) 872-5454
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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