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Organization

SHALOM BEHAVIORAL CARE LLC

Active
Parent organization
SHALOM BEHAVIORAL CARE, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SHALOM BEHAVIORAL CARE, LLC
Authorized official
ANTHONY VINCENT OLORUNSOLA (STATUTORY OFFICER)
(623) 806-6864
Entity
Organization

Contact information

Practice address
10612 E MARIGOLD LN, FLORENCE, AZ 85132-7320
(480) 684-2004
(480) 582-6043
Mailing address
10612 E MARIGOLD LN, FLORENCE, AZ 85132-7320
(480) 684-2004

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary

Other

Enumeration date
07/12/2021
Last updated
07/12/2021
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