2047 W Keim Management LLC
Community Based Residential Treatment Facility, Mental Illness in Phoenix, AZ. Organization (NPI-2).
NPI number1245882364
StatusActive
Last updated in NPPESJul 9, 2019
Details
- NPI
- 1245882364
- Entity type
- Organization (NPI-2)
- Legal business name
- 2047 W Keim Management LLC
- Organization subpart
- No
- Enumeration date
- Jul 9, 2019
- Last updated
- Jul 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 251B00000X | Case Management | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 3104A0625X | Assisted Living Facility, Assisted Living, Mental Illness | – | – | |
| 310500000X | Intermediate Care Facility, Mental Illness | – | – | |
| 324500000X | Substance Abuse Rehabilitation Facility | – | – |
Practice location
2047 W Keim DrPhoenix, AZ 85015-1527
Phone 602-888-6779 · Fax 602-429-8149
Mailing address
14362 N Frank Lloyd Wright Blvd Ste 1000Scottsdale, AZ 85260-8847
Phone 602-888-6779 · Fax 602-429-8149
Authorized official
James Guarjdo
Manager
4803840789
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