Provider Demographics
NPI:1467635698
Name:TOBY HOUSE, INC.
Entity Type:Organization
Organization Name:TOBY HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-234-3338
Mailing Address - Street 1:5717 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5802
Mailing Address - Country:US
Mailing Address - Phone:602-234-3338
Mailing Address - Fax:602-234-3398
Practice Address - Street 1:211 W BUTLER DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4522
Practice Address - Country:US
Practice Address - Phone:602-234-3338
Practice Address - Fax:602-234-3398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOBY HOUSE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-11
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-1724320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness