OrganizationActive
South Mountain Holistic Care
NPI 1770038564 · Mental Illness Intermediate Care Facility · Laveen, AZ
Provider details
- NPI number
- 1770038564
- Entity type
- Organization
- Primary specialty
- Mental Illness Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Stephanie Brigham, Executive Director
- License
- BH4914 (AZ)
Mailing address
3219 W Olney Ave
Laveen, AZ 85339
Registry dates
- Enumerated
- 2016-08-22
- Last updated
- 2016-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.