Organization
TRANSITIONAL LIVING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH BRIICK (CHIEF OPERATIONS OFFICER)
(928) 668-0722
Entity
Organization
Contact information
Practice address
466 W WICKENBURG WAY, WICKENBURG, AZ 85390-2226
(928) 668-1470
(928) 668-1474
Mailing address
466 W WICKENBURG WAY, WICKENBURG, AZ 85390-2226
(928) 668-1470
(928) 668-1474
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
BH-2644
AZ
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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