Organization
TRINITY BEHVAIORAL FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILUS MBI AKOH PMHNP-BC (ADMINISTRATOR)
(775) 335-7450
Entity
Organization
Contact information
Practice address
4535 W CRITTENDEN LN, PHOENIX, AZ 85031-2803
(775) 335-7450
Mailing address
4535 W CRITTENDEN LN, PHOENIX, AZ 85031-2803
(775) 335-7450
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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