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General NPI Number Information
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NPI Number | 1285408526
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Entity Type | Organization
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Legal Business Name | LEVIS TREATMENT CENTER LLC
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 4530 E RAY RD STE 172
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City | PHOENIX
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State | AZ
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Zip | 85044-6099
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Country | US
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Telephone | 480-906-7761
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Fax | 463-201-7899
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Provider Business Mailing Address
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Address Line | 1052 E WASHINGTON AVE
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City | GILBERT
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State | AZ
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Zip | 85234-9014
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Country | US
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Telephone | 480-906-7761
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Fax | 463-201-7899
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Authorized Official
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Title or Position | CEO
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Name | ANITA MAWAZO
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Credential |
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Telephone | 480-906-7761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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