MIRACLE ON 29TH STREET

PHOENIX, AZ
NPI1255835997
Doing Business AsKOALA-D MEDS
Entity TypeOrganization
Authorized ContactTROY BERKLEY
Owner
480-302-1101
Organization Subpart ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
(Licence: AZ  AL10509H)
Enumeration Date2018-03-19
Last Update Date2019-06-12
Business Address
MIRACLE ON 29TH STREET
18210 N 29TH ST
PHOENIX, AZ 85032-1103
Phone number: 480-302-1101
Mailing Address
MIRACLE ON 29TH STREET
18210 N 29TH ST
PHOENIX, AZ 85032-1103
Phone number: 480-302-1101