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PROVIDENCE BEHAVIORAL HEALTH LLC 1700527637

Overview
Name: PROVIDENCE BEHAVIORAL HEALTH LLC Specialty: Mental Illness Community Based Residential Treatment Facility Type of Practice: Organization Provider/Org: Medical School: Graduation year from medical school: Affiliation:
Specialties
Practice Type: Residential Treatment Facilities Classification: Community Based Residential Treatment Facility, Mental Illness Specialization: . Definition of Specialty: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
License & NPI
License #(s): , , , , License State(s): , , , ,
Addresses
Practice Location: PROVIDENCE BEHAVIORAL HEALTH LLC,8714 W PIONEER ST,TOLLESON,AZ,853538618,US Mailing Address: PROVIDENCE BEHAVIORAL HEALTH LLC,8714 W PIONEER ST,TOLLESON,AZ,853538618,US
Contact #
Practice location phone #: 6026282266 Practice location fax #: Mailing address Phone #: 6026282266 Mailing Address fax #: Authorized official Name/Telephone #:FUNMILOLA, ELIZABETH-TOSIN, OGUNLA, DIRECTOR 6026282266
Misc
Date NPI was obtained: 04/05/2022 Last data data was updated: 04/05/2022 Insurances:

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