Organization · Type 2 NPI
Eureka Imperial Residence
Mental Illness Community Based Residential Treatment Facility · Gilbert, AZ
NPI number
1679704381
Active
Practice location
1740 S Heritage Drive
Gilbert, AZ 85296
Fax (480) 264-2647
Mailing address
7110 S Champagne Way
Gilbert, AZ 85298-9122
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | BH3319 (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 1679704381
Eureka Imperial Residence's National Provider Identifier is 1679704381, issued on Jul 29, 2009. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Gilbert, AZ. The record was last updated on Jul 29, 2009.