Organization
LOOKING FORWARD BEHAVIORAL HEALTH RESIDENTIAL FACILITY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA MARGUERITE AYIYI LPN (CEO)
(602) 559-6033
Entity
Organization
Contact information
Practice address
6202 W OREGON AVE, GLENDALE, AZ 85301-6632
(602) 559-6033
(623) 322-8622
Mailing address
6202 W OREGON AVE, GLENDALE, AZ 85301-6632
(602) 559-6033
(623) 322-8622
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH4513
AZ
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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