Provider Demographics
NPI:1285408526
Name:LEVIS TREATMENT CENTER LLC
Entity type:Organization
Organization Name:LEVIS TREATMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAWAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-906-7761
Mailing Address - Street 1:1052 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-9014
Mailing Address - Country:US
Mailing Address - Phone:480-906-7761
Mailing Address - Fax:463-201-7899
Practice Address - Street 1:4530 E RAY RD STE 172
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6099
Practice Address - Country:US
Practice Address - Phone:480-906-7761
Practice Address - Fax:463-201-7899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health