Organization
CASA MAIA ALH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIANCA GILMORE (OWNER/ MANAGER)
(480) 677-9776
Entity
Organization
Contact information
Practice address
3554 E TONTO PL, CHANDLER, AZ 85249-5472
(480) 626-9328
(480) 265-9996
Mailing address
3554 E TONTO PL, CHANDLER, AZ 85249-5472
(480) 626-9328
(480) 265-9996
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
AL8946H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048019
—
AZ
Enumeration date
02/06/2016
Last updated
02/06/2016
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