Organization · NPI-2

A Greater Vision Living Space LLC.

Community/Behavioral Health · Peoria, AZ

NPI number1740974336
StatusActive
Last updated in NPPESJun 28, 2023

Details

NPI
1740974336
Entity type
Organization (NPI-2)
Legal business name
A Greater Vision Living Space LLC.
Organization subpart
No
Enumeration date
Jun 6, 2023
Certification date
Jun 28, 2023
Last updated
Jun 28, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Other names

  • A Greater Vision Living Space LLC. (Doing Business As)

Practice location

7252 W Quail Track Dr
Peoria, AZ 85383-6362

Phone 623-203-5920

Mailing address

7252 W Quail Track Dr
Peoria, AZ 85383-6362

Phone 623-203-5920

Authorized official

Crystal Roche
Owner
6232035920

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