NPI 1184492357

Providence Health LLC

Organisation Developmentally Disabled Services Day Training Agency Laveen, AZ

Practice location

Address: 6311 W Magdalena Ln, Laveen, AZ 85339-5483
Phone: (480) 434-1113

Authorised official

Name: Victory Ezenwaka
Title: Ceo/Owner
Phone: (480) 434-1113

Registered specialties

Developmentally Disabled Services Day Training Agency Primary

Agencies Taxonomy 251C00000X

Other Day Training, Developmentally Disabled Services providers in Arizona →

Registry record

NPI: 1184492357
Entity type: Organization
NPI issued: 18 Dec 2023
Record last updated: 18 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.