Organization · Type 2 NPI

The 12th Ave House #1

Mental Illness Community Based Residential Treatment Facility · Phoenix, AZ

NPI number 1013177666 Active

Practice location

9606 N 12th Ave
Phoenix, AZ 85021-3095

Call (602) 441-2691 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000XBH - 3055 (AZ)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1013177666

The 12th Ave House #1's National Provider Identifier is 1013177666, issued on Jun 16, 2008. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Phoenix, AZ. The record was last updated on Jun 16, 2008.