BACK TO LIFE INCORPORATED
NPI 1013558311
Residential Treatment Facility, Emotionally Disturbed Children in Phoenix, AZ
- Organization
- Residential Treatment Facility, Emotiona...
About BACK TO LIFE INCORPORATED
This page provides the complete NPI Profile along with additional information for Back To Life Incorporated, a provider established in Phoenix, Arizona operating as a Residential Treatment Facility, Emotionally Disturbed Children. The healthcare provider is registered in the NPI registry with number 1013558311 assigned on October 2019. The practitioner's primary taxonomy code is 322D00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Ms. Gracie Gonzalez Padilla (Chief Executive Officer)
- NPI
- 1013558311 Verify this NPI
- Provider Name
- BACK TO LIFE INCORPORATED
- Entity Type
- Organization
- Location Address
- 6420 W COCOPAH ST PHOENIX, AZ 85043
- Location Phone
- (602) 999-2400
- Location Fax
- (623) 444-7829
- Mailing Address
- PO BOX 8237 PHOENIX, AZ 85066
- Mailing Phone
- (602) 999-2400
- Mailing Fax
- (623) 444-7829
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-08-2019
- Last Update Date
- 10-08-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Residential Treatment Facility, Emotionally Disturbed Children
- Taxonomy Code
- 322D00000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1013558311, enumerated as an "organization" on October 08, 2019.
The provider is located at 6420 W COCOPAH ST PHOENIX, AZ 85043 and the phone number is (602) 999-2400.
Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.
