Provider Demographics
NPI:1477193191
Name:RICHLIN REGAL RESIDENCY
Entity type:Organization
Organization Name:RICHLIN REGAL RESIDENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOWUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-288-3657
Mailing Address - Street 1:7872 S ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-7449
Mailing Address - Country:US
Mailing Address - Phone:602-288-3657
Mailing Address - Fax:602-532-7333
Practice Address - Street 1:6671 S CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-4038
Practice Address - Country:US
Practice Address - Phone:602-288-3657
Practice Address - Fax:602-532-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility