Provider Demographics
NPI:1225805856
Name:GRATEFUL AND BEYOND RECOVERY HOMES LLC
Entity Type:Organization
Organization Name:GRATEFUL AND BEYOND RECOVERY HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHOEBE
Authorized Official - Middle Name:
Authorized Official - Last Name:NALUBEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-770-1879
Mailing Address - Street 1:8820 W LAMAR RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3421
Mailing Address - Country:US
Mailing Address - Phone:818-770-1879
Mailing Address - Fax:
Practice Address - Street 1:8820 W LAMAR RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3421
Practice Address - Country:US
Practice Address - Phone:818-770-1879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable