Organization
PARADISE SPRINGS HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA WILSON MSW, LBHT (CHIEF OF OPERATIONS)
(213) 373-3549
Entity
Organization
Contact information
Practice address
5235 S AXIOM, MESA, AZ 85212-8529
(213) 373-3549
Mailing address
2777 S ARIZONA AVE APT 1183, CHANDLER, AZ 85286-1808
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096170
—
AZ
01
—
BH6860
AZ DHS
AZ
Enumeration date
07/14/2021
Last updated
11/13/2021
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