NPI 1396520011

Family Home LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Avondale, AZ

Practice location

Address: 10423 W Edgemont Dr, Avondale, AZ 85392-4652
Phone: (480) 358-7850
Mailing address: 6035 W Kristal Way, Glendale, AZ 85308-7802

Authorised official

Name: Mojok Ajawin
Title: Manager/Owner
Phone: (480) 358-7850

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Arizona →

Registry record

NPI: 1396520011
Entity type: Organization
NPI issued: 30 Aug 2023
Record last updated: 30 Aug 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.