Archaic Lifestyle, Inc.
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Maricopa, AZ
NPI 1376230896 · NPPES record last updated Aug 26, 2023
Key facts
- NPI
- 1376230896
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- ARCHAIC LIFESTYLE, INC.
- Practice address
- 41768 W Barcelona Dr
Maricopa, AZ 85138-4445 - Phone
- (562) 506-3974
- NPI assigned
- Apr 24, 2023
- Organization subpart
- No
Authorized official
- Name
- Latriece Session
- Title
- Authorized Agent
- Phone
- (562) 506-3974
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
41768 W Barcelona Dr
Maricopa, AZ 85138-4445
Mailing address
41768 W Barcelona Dr
Maricopa, AZ 85138-4445
Phone (562) 506-3974
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- Arizona Dental Professionals, P.C.
- Arizona Foundation for Social Justice Children and Youth Services
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All providers in Maricopa, AZ · Mental Illness Community Based Residential Treatment Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.