Organization
ELEVENTH HOURS FOUNTAIN OF YOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY C LYLES (OWNER)
(480) 869-5550
Entity
Organization
Contact information
Practice address
1025 E SILVERLAKE RD, TUCSON, AZ 85713-3227
(480) 869-5550
Mailing address
1254 E 24TH ST, TUCSON, AZ 85713-1846
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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