Organization
MILE HIGH DEVELOPERS LLC
Active
Organization
MILE HIGH DEVELOPERS LLC
Active
Other names
Phoenix House Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE ANN FITZGERALD (OWNER)
(928) 899-8585
Entity
Organization
Contact information
Practice address
13651 N 32ND ST, PHOENIX, AZ 85032-6025
(928) 899-8585
Mailing address
4643 E KATHLEEN RD, PHOENIX, AZ 85032-4215
(602) 354-3692
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092283
—
AZ
01
—
OTC11873
OUTPATIENT TREATMENT CENTER LICENSE AZDHS
AZ
Enumeration date
04/15/2021
Last updated
08/16/2022
Update your record
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