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Organization

AZ PEACE OF MIND BEHAVIORAL HEALTH HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELVINE MUTETERI (ADMINISTRATOR)
(623) 214-6420
Entity
Organization

Contact information

Practice address
15622 W SIERRA ST, SURPRISE, AZ 85379-1038
(623) 214-6420
Mailing address
15622 W SIERRA ST, SURPRISE, AZ 85379-1038

Taxonomy

Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320800000X
Mental Illness Community Based Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
07/10/2020
Last updated
07/10/2020
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