Organization
JRW RESIDENTIAL SERVICES LLC
Active
Other names
Dreamlife Residential Homes
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AARON WRIGHT (MANAGING PARTNER)
(623) 210-4872
Entity
Organization
Contact information
Practice address
2428 W SAGEBRUSH DR, PHOENIX, AZ 85085-5026
(623) 210-4872
Mailing address
2428 W SAGEBRUSH DR, PHOENIX, AZ 85085-5026
(623) 210-4872
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH5262
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303942
—
AZ
Enumeration date
05/02/2018
Last updated
05/02/2018
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