Provider Demographics
NPI:1982130126
Name:RESIDENTS AT THE HEIGHTS, LLC
Entity Type:Organization
Organization Name:RESIDENTS AT THE HEIGHTS, LLC
Other - Org Name:UNHOOKED RECOVERY MAIN STREET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-368-8203
Mailing Address - Street 1:215 S POWER RD STE 1251
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-5238
Mailing Address - Country:US
Mailing Address - Phone:602-368-4471
Mailing Address - Fax:602-368-8211
Practice Address - Street 1:5801 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8851
Practice Address - Country:US
Practice Address - Phone:602-368-4471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-09
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC8147251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health