Organization
ELEVATE BEHAVIORAL HEALTH RESIDENTIAL FACILITIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA WHITAKER (OWNER)
(623) 562-0128
Entity
Organization
Contact information
Practice address
2029 N 106TH AVE, AVONDALE, AZ 85392-4766
(623) 562-0128
Mailing address
2029 N 106TH AVE, AVONDALE, AZ 85392-4766
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/02/2020
Last updated
05/02/2020
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