| NPI | 1568853752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOISE KELLY President 480-277-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ 957399) |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) (Licence: AZ 957399) |
| 251B00000X Case Management (Licence: AZ 957399) | |
| 251C00000X Day Training, Developmentally Disabled Services (Licence: AZ 957399) | |
| 251E00000X Home Health (Licence: AZ 957399) | |
| 251K00000X Public Health or Welfare (Licence: AZ 957399) | |
| 252Y00000X Early Intervention Provider Agency (Licence: AZ 957399) | |
| 253Z00000X In Home Supportive Care (Licence: AZ 957399) | |
| 305R00000X Preferred Provider Organization (Licence: AZ 957399) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ 957399) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AZ 957399) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: AZ 957399) | |
| 385H00000X Respite Care (Licence: AZ 957399) | |
| 385HR2050X Respite Care, Respite Care Camp (Licence: AZ 957399) | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |