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General NPI Number Information
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NPI Number | 1447842976
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Entity Type | Organization
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Legal Business Name | FLOWING SPRING BEHAVIORAL HOME HEALTH
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Dates
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Enumeration Date | 02/05/2021
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 25284 N POSEIDON ROAD
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City | FLORENCE
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State | AZ
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Zip | 85132
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Country | US
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Telephone | 480-241-9586
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Fax |
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Provider Business Mailing Address
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Address Line | 1632 E LESLIE AVE
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-4077
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Country | US
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Telephone | 480-241-9586
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Fax |
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MRS. JENEVE ATUH TEBECK
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Credential |
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Telephone | 480-241-9586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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