A Heart of Gold Home LLC

Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · San Tan Valley, AZ

NPI 1508622960 · NPPES record last updated Feb 23, 2024

Key facts

NPI
1508622960
Entity type
Organization (NPI type 2)
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
Legal business name
A HEART OF GOLD HOME LLC
Practice address
1958 E Renegade TRL
San Tan Valley, AZ 85143-4460
Phone
(928) 250-9436
NPI assigned
Feb 23, 2024
Organization subpart
No

Authorized official

Name
Leighann Johnson NPI 1629726583
Title
Owner
Phone
(928) 250-9436

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Yes

Addresses

Primary practice location

1958 E Renegade TRL
San Tan Valley, AZ 85143-4460

Mailing address

1958 E Renegade TRL
San Tan Valley, AZ 85143-4460

Other providers in San Tan Valley, AZ

All providers in San Tan Valley, AZ · Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

Sources for this page

Verify at the official NPI Registry.