Organization · NPI-2

Alpine Villa Group LLC

Community/Behavioral Health · Peoria, AZ

NPI number1881209583
StatusActive
Last updated in NPPESSep 10, 2020

Details

NPI
1881209583
Entity type
Organization (NPI-2)
Legal business name
Alpine Villa Group LLC
Organization subpart
No
Enumeration date
Sep 10, 2020
Certification date
Sep 10, 2020
Last updated
Sep 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Practice location

8845 W Potter Dr
Peoria, AZ 85382-6428

Phone 602-292-2010

Mailing address

8845 W Potter Dr
Peoria, AZ 85382-6428

Phone 602-292-2010

Authorized official

Eric Glade Maughan
Member
6022922010

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