Organization
EUREKA IMPERIAL RESIDENCE 3
Active
Parent organization
EUREKA IMPERIAL RESIDENCE
Organization subpart
Yes
Provider details
NPI number
Legal business name
EUREKA IMPERIAL RESIDENCE
Authorized official
CORNELIUS TANYI (PROGRAM DIRECTOR)
(480) 264-2647
Entity
Organization
Contact information
Practice address
1080 E CLIFTON AVE, GILBERT, AZ 85295-1135
(480) 264-2647
Mailing address
1080 E CLIFTON AVE, GILBERT, AZ 85295-1135
(480) 264-2647
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/12/2017
Last updated
07/21/2022
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