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General NPI Number Information
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NPI Number | 1679019129
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Entity Type | Organization
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Legal Business Name | SONORAN SKY COMMUNITY SERVICES
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 19808 N 42ND AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-2291
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Country | US
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Telephone | 623-780-3583
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Fax | 602-674-0942
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Provider Business Mailing Address
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Address Line | 23005 N 15TH AVE STE 205
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City | PHOENIX
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State | AZ
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Zip | 85027-6309
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Country | US
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Telephone | 602-216-0518
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Fax |
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | DEBRA QUIROZ
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Credential |
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Telephone | 602-216-0518
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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 | BH4769
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License Number State | AZ
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