Organization · NPI-2

145th Lane

Community Based Residential Treatment Facility, Mental Illness · Surprise, AZ

NPI number1083876825
StatusActive
Last updated in NPPESJul 1, 2008

Details

NPI
1083876825
Entity type
Organization (NPI-2)
Legal business name
145th Lane
Organization subpart
No
Enumeration date
Jul 1, 2008
Last updated
Jul 1, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320800000X Community Based Residential Treatment Facility, Mental IllnessBH - 3107AZYes

Other names

  • L3 Residential Facilities, LLC (Doing Business As)

Practice location

15266 N 145th Ln
Surprise, AZ 85379-8519

Phone 602-441-2691

Mailing address

15266 N 145th Ln
Surprise, AZ 85379-8519

Phone 602-441-2691

Authorized official

Elizabeth Singleton
Administator
6024412691

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