Provider Demographics
NPI:1073319968
Name:AZ INTERACT LLC
Entity type:Organization
Organization Name:AZ INTERACT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-410-3606
Mailing Address - Street 1:2325 W DESPERADO WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-5777
Mailing Address - Country:US
Mailing Address - Phone:602-410-3606
Mailing Address - Fax:623-398-8980
Practice Address - Street 1:6427 W WETHERSFIELD RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1629
Practice Address - Country:US
Practice Address - Phone:602-410-3606
Practice Address - Fax:623-398-8980
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AZ INTERACT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-20
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness