Provider Demographics
NPI:1851077119
Name:ALLENA'S HOUSE LLC
Entity Type:Organization
Organization Name:ALLENA'S HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANNIGAN
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:602-582-4166
Mailing Address - Street 1:5417 S 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2405
Mailing Address - Country:US
Mailing Address - Phone:602-935-1002
Mailing Address - Fax:
Practice Address - Street 1:2225 W ALTA VISTA RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-5420
Practice Address - Country:US
Practice Address - Phone:602-935-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty