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1194198697
AMANDA ELLIS
SAN TAN VALLEY, AZ
NPI
1194198697
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
320700000X Residential Treatment Facility, Physical Disabilities
(Licence: AZ D05686544)
Enumeration Date
2015-11-05
Last Update Date
2015-11-05
Business Address
-- AMANDA ELLIS
381 EAST BROOK STREET
SAN TAN VALLEY, AZ 85140
Phone number: 480-495-2839
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Mailing Address
-- AMANDA ELLIS
381 E BROOK ST
SAN TAN VALLEY, AZ 85140
Phone number: 480-495-2839
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