Organization
MODERN RECOVERY, INC.
Active
Other names
Virgil- Phoenix
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE BAHBAH (DIRECTOR OF RCM)
(754) 270-6654
Entity
Organization
Contact information
Practice address
112 N CENTRAL AVE # 130, PHOENIX, AZ 85004-2309
(844) 991-0555
Mailing address
112 N CENTRAL AVE # 130, PHOENIX, AZ 85004-2309
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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