Destiny Behavioral Health Residential Care LLC 5

NPI #1265949861 in Tolleson, Arizona

Provider Information

NPI Number: 1265949861
Entity Type: Organization
Organization Name: Destiny Behavioral Health Residential Care LLC 5
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Jan 4, 2018
Last Updated: Jan 4, 2018

Practice Location

Address: 10313 W HESS STREET
City: Tolleson
State: Arizona
ZIP Code: 85353
Phone: (602) 384-8820

Authorized Official

Name: MR. FUNSO FEYI OGUNLA
Title: PROGRAM DIRECTOR
Phone: (602) 384-8820

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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