AGAVE RESIDENTIAL CARE HOME, LLC

LAVEEN, AZ
NPI1376058065
Entity TypeOrganization
Authorized ContactAMANDA UBIEBOR
Administrator
602-802-9655
Organization Subpart ?No
Primary Taxonomy320800000X Community Based Residential Treatment Facility, Mental Illness
(Licence: AZ  BH301)
Enumeration Date2017-12-05
Last Update Date2021-08-28
Business Address
AGAVE RESIDENTIAL CARE HOME, LLC
5628 W GLASS LN
LAVEEN, AZ 85339-2278
Phone number: 602-802-9655
Mailing Address
AGAVE RESIDENTIAL CARE HOME, LLC
3007 N ARROWHEAD DR
CHANDLER, AZ 85224-1301
Phone number: 602-802-9655