ARCHAIC LIFESTYLE INC. NPI 1376230896

NPI Information

NPI: 1376230896
Provider Name: ARCHAIC LIFESTYLE, INC.
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
41768 W BARCELONA DR
MARICOPA, AZ
ZIP 85138
Phone: (562) 506-3974
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ARCHAIC LIFESTYLE, INC. is a community based residential treatment facility mental illness in Maricopa, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. ARCHAIC LIFESTYLE, INC. NPI is 1376230896. The provider is registered as an organization entity type.

The provider's business location address is:

41768 W BARCELONA DR
MARICOPA, AZ
ZIP 85138-445
Phone: (562) 506-3974

The provider's authorized official is Latriece Session .
The authorized official title is Authorized Agent and has the following contact phone number (562) 506-3974.

The enumeration date for this NPI number is 4/24/2023 and was last updated on 8/26/2023.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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