Provider Demographics
NPI:1063205847
Name:VALOR MOUNTAIN WELLNESS
Entity type:Organization
Organization Name:VALOR MOUNTAIN WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-320-6984
Mailing Address - Street 1:5850 E CONCHO ST
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85119-9430
Mailing Address - Country:US
Mailing Address - Phone:425-320-6984
Mailing Address - Fax:
Practice Address - Street 1:5850 E CONCHO ST
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85119-9430
Practice Address - Country:US
Practice Address - Phone:425-320-6984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility