BACK TO LIFE INCORPORATED NPI 1013558311

NPI Information

BACK TO LIFE INCORPORATED is a residential treatment facility emotionally disturbed children in Phoenix, AZ. The provider is 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. BACK TO LIFE INCORPORATED NPI is 1013558311. The provider is registered as an organization entity type.

The provider's business location address is:

6420 W COCOPAH ST
PHOENIX, AZ
ZIP 85043
Phone: (602) 999-2400
Fax: (623) 444-7829

The provider's authorized official is Gracie Gonzalez Padilla .
The authorized official title is Chief Executive Officer and has the following contact phone number (623) 518-9552.

The enumeration date for this NPI number is 10/8/2019 and was last updated on 10/8/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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