National Provider Identifier Database

VALLEY INDEPENDENT RESIDENTIAL LLC
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.


Contact Information

VALLEY INDEPENDENT RESIDENTIAL LLC
6408 W GROSS AVE
PHOENIX, AZ85043
Phone: 623-907-1142
Fax: 623-907-1143
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Mental Illness 320800000X

* Indicates primary specialty

NPI Profile & details for VALLEY INDEPENDENT RESIDENTIAL LLC

NPI Number 1558704809
Legal business name
LBN
VALLEY INDEPENDENT RESIDENTIAL LLC
Authorized official AUGUSTINE MCCABE - (OWER)
Entity Organization
Organization subpart No
Enumeration date 04/16/2013
Last updated 04/16/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: BH4203

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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