Back To Life, Incorporated

LBN: Back To Life, Incorporated
Back To Life, Incorporated is an health care organization with primary practice located at 5915 W Roanoke Ave , Phoenix AZ 85035-1639. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Back To Life, Incorporated can be contacted via phone (623) 594-4870, or through Contreras, Gracie Padilla via phone (623) 594-4870.

Contact Information

Primary practice address
5915 W Roanoke Ave Phoenix AZ 85035-1639
Phone: (623) 594-4870
Fax: (623) 444-9213
Website:
Map and Directions
Authorized official contact:
Name: Contreras, Gracie Padilla
Phone: (623) 594-4870

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X BH2772 Arizona

Profile Details

NPI number 1497937767
LBN Legal business name Back To Life, Incorporated
DBA Doing business as
Authorized official Contreras, Gracie Padilla
Entity Organization
Organization subpart 1 No
Enumeration date Nov 28th, 2007
Last updated Nov 29th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497937767 NPPES
Arizona MEDICAID 143580

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