Provider Demographics
NPI:1184330045
Name:MERTON HEALTH SERVICE LLC
Entity type:Organization
Organization Name:MERTON HEALTH SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURIUKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-371-2881
Mailing Address - Street 1:815 E WARNER RD STE B100
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1057
Mailing Address - Country:US
Mailing Address - Phone:520-280-4613
Mailing Address - Fax:520-423-3269
Practice Address - Street 1:815 E WARNER RD STE B100
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1057
Practice Address - Country:US
Practice Address - Phone:520-280-4613
Practice Address - Fax:520-423-3269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness