Destiny Sober Living Ii Carver Ranch

LBN: Destiny Sober Living Ii Carver Ranch
Destiny Sober Living Ii Carver Ranch is an health care organization with primary practice located at 11629 S 43Rd Ave , Laveen AZ 85339-3245. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. Destiny Sober Living Ii Carver Ranch can be contacted via phone (602) 249-6685, or through Lewis, Marcus J via phone (602) 249-6675.

Contact Information

Primary practice address
11629 S 43Rd Ave Laveen AZ 85339-3245
Phone: (602) 249-6685
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lewis, Marcus J
Phone: (602) 249-6675

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X Arizona

Profile Details

NPI number 1265849939
LBN Legal business name Destiny Sober Living Ii Carver Ranch
DBA Doing business as
Authorized official Lewis, Marcus J
Entity Organization
Organization subpart 1 No
Enumeration date Jul 15th, 2014
Last updated Jul 15th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265849939 NPPES
Arizona MEDICAID 438-43-1827

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