Organization
SOUTH PHOENIX INTEGRITY HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARA L CARLOS (OWNER)
(520) 907-1437
Entity
Organization
Contact information
Practice address
1612 E SOUTHERN AVE, PHOENIX, AZ 85040-3534
(520) 907-1437
Mailing address
1612 E SOUTHERN AVE, PHOENIX, AZ 85040-3534
(520) 907-1437
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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