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NPI 1386969947 · Physical Disabilities Residential Treatment Facility · Phoenix, AZ
Provider details
- NPI number
- 1386969947
- Entity type
- Organization
- Primary specialty
- Physical Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Imelda Melissa Noriega, Administrator(602) 643-5932
- License
- ALH6076 (AZ)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
5116 S 11th Ave
Phoenix, AZ 85041-2363
Phone: (602) 643-5932
Fax: (602) 281-6974
Approximate (ZIP-level) locationGet directions
Mailing address
5415 S 5th Ave
Phoenix, AZ 85041-4000
Registry dates
- Enumerated
- 2010-04-07
- Last updated
- 2010-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.