| NPI | 1053615906 |
|---|---|
| Doing Business As | HERITAGE LANE BEHAVIORAL ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | REED T GUNNELL Owner 480-307-8809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: AZ al7718c) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2022-05-05 |