Organization
RANCHO BELLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK REIGELSPERGER (OWNER)
(602) 622-7731
Entity
Organization
Contact information
Practice address
21609 N 12TH AVE STE 600, PHOENIX, AZ 85027-2850
(602) 622-7731
Mailing address
21609 N 12TH AVE STE 600, PHOENIX, AZ 85027-2850
(602) 622-7731
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/21/2023
Last updated
10/30/2023
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