Organization · NPI-2

The River Source Treatment Center Casa Grande, LLC

Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children · Gilbert, AZ

NPI number1851004220
StatusActive
Last updated in NPPESOct 7, 2024

Details

NPI
1851004220
Entity type
Organization (NPI-2)
Legal business name
The River Source Treatment Center Casa Grande, LLC
Organization subpart
No
Enumeration date
Jan 2, 2023
Certification date
Oct 7, 2024
Last updated
Oct 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children––Yes

Practice location

2325 W Guadalupe Rd Bldg 2 Ste 107
Gilbert, AZ 85233-2811

Phone 866-367-8069 · Fax 520-413-5944

Mailing address

Po Box 4293
Arizona City, AZ 85123-2669

Phone 480-298-7301 · Fax 520-413-5944

Authorized official

Christina Valencia
Finance Director
4802987301

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children providers in Gilbert, AZ