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General NPI Number Information
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NPI Number | 1356927354
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Entity Type | Organization
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Legal Business Name | NATIVE JOURNEY
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Dates
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Enumeration Date | 03/20/2021
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 1525 S HIGLEY RD STE 104
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City | GILBERT
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State | AZ
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Zip | 85296-5045
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Country | US
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Telephone | 928-693-4607
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 S HIGLEY RD STE 104
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City | GILBERT
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State | AZ
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Zip | 85296-5045
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Country | US
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Telephone | 928-693-4607
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JAMIE FRY
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Credential |
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Telephone | 702-600-2896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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