Provider Demographics
NPI:1881563476
Name:ADVOCATE BEHAVIORAL HOME LLC
Entity type:Organization
Organization Name:ADVOCATE BEHAVIORAL HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSELETTI C
Authorized Official - Middle Name:C
Authorized Official - Last Name:CABUNGCAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-248-5718
Mailing Address - Street 1:8605 W HELEN LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3956
Mailing Address - Country:US
Mailing Address - Phone:602-248-5718
Mailing Address - Fax:602-248-5718
Practice Address - Street 1:8605 W HELEN LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3956
Practice Address - Country:US
Practice Address - Phone:602-248-5718
Practice Address - Fax:602-248-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-01
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility