OrganizationActive
Archaic Lifestyle, Inc.
NPI 1376230896 · Mental Illness Community Based Residential Treatment Facility · Maricopa, AZ
Provider details
- NPI number
- 1376230896
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Latriece Session, Authorized Agent(562) 506-3974
Specialties & taxonomies
Residential Treatment Facilities
Practice location
41768 W Barcelona Dr
Maricopa, AZ 85138-4445
Phone: (562) 506-3974
Approximate (ZIP-level) locationGet directions
Mailing address
41768 W Barcelona Dr
Maricopa, AZ 85138-4445
Registry dates
- Enumerated
- 2023-04-24
- Last updated
- 2023-08-26
- Certified
- 2023-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.