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Contact Information

VALLEY INDEPENDENT RESIDENTIAL LLC
6408 W GROSS AVE
PHOENIX, AZ85043
 Phone: 623-907-1142
 Fax: 623-907-1143
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Based Residential Treatment Facility, Mental Illness

320800000X
Indicates primary specialty

NPI Profile & details for VALLEY INDEPENDENT RESIDENTIAL LLC

NPI # 1558704809
LBN Legal business name VALLEY INDEPENDENT RESIDENTIAL LLC
Authorized official AUGUSTINE MCCABE - (OWER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/16/2013
Last updated 04/16/2013 - About 13 years ago
Identifiers
AZ License # BH4203
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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