Organization
SPRINGBROOK HABILITATION SERVICES, LLC
Active
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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