Provider Demographics
NPI:1154931566
Name:APEX TRANSITIONAL HOUSING INC
Entity type:Organization
Organization Name:APEX TRANSITIONAL HOUSING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:CORNELL
Authorized Official - Last Name:EARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-650-8095
Mailing Address - Street 1:7614 W NORTHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-1929
Mailing Address - Country:US
Mailing Address - Phone:480-650-8095
Mailing Address - Fax:888-292-0677
Practice Address - Street 1:13827 N 11TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4316
Practice Address - Country:US
Practice Address - Phone:480-650-8095
Practice Address - Fax:888-292-0677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APEX TRANSITIONAL HOUSING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-01
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health