Organization
A-MAKING CHANGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN JETER PHD (CEO)
(480) 521-4815
Entity
Organization
Contact information
Practice address
1010 W EUCLID AVE, PHOENIX, AZ 85041-8345
(480) 521-4815
Mailing address
2942 N 24TH ST # 114-766, PHOENIX, AZ 85016-7844
(480) 521-4815
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
09/06/2023
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