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Organization

CINDY HICKS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CINDY HICKS (OWNER)
(602) 547-9682
Entity
Organization

Contact information

Practice address
4602 W MONTE CRISTO AVE, GLENDALE, AZ 85306-2724
(602) 547-9682
Mailing address
4602 W MONTE CRISTO AVE, GLENDALE, AZ 85306-2724

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
BH2617
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016782
AZ
01
BH2617
BEHAVIORAL HEALTH LICENSE
AZ
Enumeration date
01/16/2007
Last updated
06/23/2008
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