Organization
LITTLEBITOFALOT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID LEE WILSON (CEO/OWNER)
(602) 587-4233
Entity
Organization
Contact information
Practice address
4539 N 22ND ST # 4584, PHOENIX, AZ 85016-4639
(602) 844-7114
Mailing address
4539 N 22ND ST # 4584, PHOENIX, AZ 85016-4639
(602) 844-7114
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/13/2025
Last updated
06/13/2025
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