Healthcare Provider Details

I. General information

NPI: 1649105560
Provider Name (Legal Business Name): PHOENIX HAPPY LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7506 S 45TH AVE
LAVEEN AZ
85339-4296
US

IV. Provider business mailing address

7245 N 74TH AVE
GLENDALE AZ
85303-3046
US

V. Phone/Fax

Practice location:
  • Phone: 602-318-7700
  • Fax:
Mailing address:
  • Phone: 602-318-7700
  • Fax: 602-318-7700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MILLION AYELE FIREW
Title or Position: OWNER
Credential:
Phone: 602-318-7700