Soul Purpose Transitional Home LLC
Community Based Residential Treatment Facility, Mental Illness in Buckeye, AZ. Organization (NPI-2).
NPI number1114659596
StatusActive
Last updated in NPPESNov 15, 2022
Details
- NPI
- 1114659596
- Entity type
- Organization (NPI-2)
- Legal business name
- Soul Purpose Transitional Home LLC
- Organization subpart
- No
- Enumeration date
- Jun 25, 2022
- Certification date
- Nov 15, 2022
- Last updated
- Nov 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | – | – |
Practice location
30041 W Earll DrBuckeye, AZ 85396-3178
Phone 480-225-4044
Mailing address
Po Box 8612Surprise, AZ 85374-0126
Phone 480-225-4044
Authorized official
Richard F Cadogan
Coo
4802254044
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