Organization
PURE WATER RECOVERY AND SOBER LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET MILLER (OWNER)
(248) 212-5615
Entity
Organization
Contact information
Practice address
15385 W FILLMORE ST UNIT 210, GOODYEAR, AZ 85338-4187
(248) 212-5615
Mailing address
15385 W FILLMORE ST UNIT 210, GOODYEAR, AZ 85338-4187
(248) 212-5615
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/04/2020
Last updated
01/18/2022
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