Home Away From Home Behavioral Health Residential Facility

NPI 1053702563 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1053702563
Enumeration Date 02/05/2015
Last Updated 02/05/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name TANYA M TANYA
Position ADMINISTRATOR
Phone (623) 312-3485
Fax
Practice Location
8572 W PALO VERDE AVE
PEORIA AZ, 85345-5354, US
Phone (623) 312-3485
Fax
Business Location
8572 W PALO VERDE AVE
PEORIA AZ, 85345-5354, US
Phone (623) 312-3485
Fax
Toxanomy
Taxonomy Code 322D00000X
License State Arizona
License Number BH4513
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According to our database, Home Away From Home Behavioral Health Residential Facility NPI is 1053702563, taxonomy code is 322D00000X and license number is BH4513, license state is located at Arizona. Home Away From Home Behavioral Health Residential Facility physically located at 8572 W Palo Verde Ave, Peoria AZ, 85345-5354. NPI Number 1033115704 has the healthcare provider type.

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1053702563 NPI number is provided on an as is basis without warranty of any kind. 1053702563 is maintained by the National Plan & Provider Enumeration System. The contents of Home Away From Home Behavioral Health Residential Facility are for informational purposes only.