Provider Demographics
NPI:1619505054
Name:JOY RECOVERY AND BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:JOY RECOVERY AND BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR, BHP
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPC, LASAC
Authorized Official - Phone:623-628-7026
Mailing Address - Street 1:17738 W DAHLIA DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-5663
Mailing Address - Country:US
Mailing Address - Phone:623-628-7026
Mailing Address - Fax:
Practice Address - Street 1:24212 N 42ND DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-3232
Practice Address - Country:US
Practice Address - Phone:623-628-7026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness