institution
The 12th Ave House #1
Mental Illness Community Based Residential Treatment Facility in Phoenix, Arizona
NPI 1013177666

The 12th Ave House #1 is a Mental Illness Community Based Residential Treatment Facility based in Phoenix, AZ. The 12th Ave House #1 practices in Phoenix, AZ. The NPI Number for The 12th Ave House #1 is 1013177666 and holds a License No. BH - 3055 (Arizona).

The current practice location address for The 12th Ave House #1 is 9606 N 12Th Ave, Phoenix, AZ and can be reached out via phone at 602-441-2691.

Location: 9606 N 12Th Ave, Phoenix, AZ, 85021-3095
institution
Provider Profile Details
NPI Number
1013177666
Provider Name
The 12th Ave House #1
Credential
Provider Entity Type
Organization
Address
9606 N 12Th Ave, Phoenix, AZ, 85021-3095
Phone Number
602-441-2691
Fax Number
Provider Enumeration Date
06/16/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9606 N 12Th Ave
City
State
Zip
85021-3095
Phone Number
602-441-2691
Fax Number
person
Provider Business Mailing Address Details
Address
9606 N 12Th Ave
City
State
Zip
85021-3095
Phone Number
602-441-2691
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
License No.
BH - 3055 (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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