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Sue Samuel
Mental Illness Community Based Residential Treatment Facility in Vail, Arizona
NPI 1003982646

Sue Samuel is a Mental Illness Community Based Residential Treatment Facility based in Vail, AZ. Sue Samuel practices in Vail, AZ. The NPI Number for Sue Samuel is 1003982646 and holds a License No. BH-2713 (Arizona).

The current practice location address for Sue Samuel is 13218 E Mineta Ridge Dr, Vail, AZ and can be reached out via phone at 520-762-5072.

Location: 13218 E Mineta Ridge Dr, Vail, AZ, 85641-2520
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003982646
Provider Name
Sue Samuel
Credential
Provider Entity Type
Individual
Gender
Female
Address
13218 E Mineta Ridge Dr, Vail, AZ, 85641-2520
Phone Number
520-762-5072
Fax Number
Provider Enumeration Date
11/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
749286 05 AZ
institution
Provider Business Practice Location Address Details
Address
13218 E Mineta Ridge Dr
City
Vail
State
Arizona
Zip
85641-2520
Phone Number
520-762-5072
Fax Number
person
Provider Business Mailing Address Details
Address
13218 E Mineta Ridge Dr
City
Vail
State
Arizona
Zip
85641-2520
Phone Number
520-762-5072
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
BH-2713 (Arizona)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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