Provider Demographics
NPI:1093306409
Name:JOINT HEALING OPERATIONS ALPHA HOUSE LLC
Entity Type:Organization
Organization Name:JOINT HEALING OPERATIONS ALPHA HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-791-2316
Mailing Address - Street 1:42796 W IRENE RD STE A
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-5898
Mailing Address - Country:US
Mailing Address - Phone:602-388-6136
Mailing Address - Fax:
Practice Address - Street 1:42796 W IRENE RD STE A
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-5898
Practice Address - Country:US
Practice Address - Phone:602-388-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness