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General NPI Number Information
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NPI Number | 1427910785
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Entity Type | Organization
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Legal Business Name | MAIDEN VOYAGE LLC
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 14188 W HOPE DR
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City | SURPRISE
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State | AZ
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Zip | 85379-4344
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Country | US
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Telephone | 520-614-8647
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Fax |
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Provider Business Mailing Address
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Address Line | 6599 N ORACLE RD STE B
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City | TUCSON
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State | AZ
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Zip | 85704-5614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP OF PROGRAM INTEGRITY
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Name | BROOKE SGUARDO
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Credential |
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Telephone | 520-614-8647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation 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 | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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