Organization
LAVIE BEHAVIORAL HOME
Active
Other names
Lavie behavioral Home
Organization subpart
No
Provider details
NPI number
Authorized official
GABY NGOUNDJO (OWNER)
(480) 249-9851
Entity
Organization
Contact information
Practice address
3043 W BUTLER DR, PHOENIX, AZ 85051-3940
(602) 314-6963
Mailing address
3043 W BUTLER DR, PHOENIX, AZ 85051-3940
(602) 314-6963
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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