Organization
SPRINGBROOK HABILITATION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE W. GREEN JR. M.ED. (CLINICAL DIRECTOR)
(602) 424-1838
Entity
Organization
Contact information
Practice address
12002 N 28TH ST, PHOENIX, AZ 85028-1114
(602) 795-2088
Mailing address
4835 E CACTUS RD, SUITE 460, SCOTTSDALE, AZ 85254-4191
(602) 424-1838
(602) 424-7879
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-2372
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
819013
—
AZ
Enumeration date
03/19/2008
Last updated
12/28/2009
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