BACK TO LIFE, INC
NPI 1255504445
Residential Treatment Facility, Emotionally Disturbed Children in Glendale, AZ
- Organization
- Residential Treatment Facility, Emotiona...
About BACK TO LIFE, INC
This page provides the complete NPI Profile along with additional information for Back To Life, Inc, a provider established in Glendale, Arizona operating as a Residential Treatment Facility, Emotionally Disturbed Children. The healthcare provider is registered in the NPI registry with number 1255504445 assigned on April 2008. The practitioner's primary taxonomy code is 322D00000X with license number BH-3045 (AZ). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Mrs. Gracie Padilla Contreras (Chief Executive Officer)
- NPI
- 1255504445 Verify this NPI
- Provider Name
- BACK TO LIFE, INC
- Entity Type
- Organization
- Location Address
- 20011 N 77TH AVE GLENDALE, AZ 85308
- Location Phone
- (623) 271-7843
- Mailing Address
- PO BOX 8237 PHOENIX, AZ 85066
- Mailing Phone
- (623) 594-4870
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-08-2008
- Last Update Date
- 04-08-2008
- 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
- License No.
- BH-3045
- License State
- AZ
- 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 1255504445, enumerated as an "organization" on April 08, 2008.
The provider is located at 20011 N 77TH AVE GLENDALE, AZ 85308 and the phone number is (623) 271-7843.
Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.
