Provider Demographics
NPI:1205716909
Name:THE LEON&ALINE HOUSE
Entity type:Organization
Organization Name:THE LEON&ALINE HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-203-9107
Mailing Address - Street 1:706 E SOUTHERN AVE APT 319
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-0105
Mailing Address - Country:US
Mailing Address - Phone:480-203-9107
Mailing Address - Fax:480-203-9107
Practice Address - Street 1:706 E SOUTHERN AVE APT 319
Practice Address - Street 2:APT 319
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-0105
Practice Address - Country:US
Practice Address - Phone:480-203-9107
Practice Address - Fax:480-203-9107
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LEON&ALINE HOUSE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty