Whalio Doctors

NPI 1427502947

Az Interact LLC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Glendale, AZ

Practice location

Address
6055 West Caribe Lane, Glendale, AZ 85306
Phone
(602) 487-8806
Mailing address
2325 W Desperado Way, Phoenix, AZ 85085-5777

Authorised official

Name
Eduardo Santana
Title
Supervisor
Phone
(602) 487-8806

Registered specialties (3)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X Licence BH4514 (AZ)
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320600000X Licence BH4802 (AZ)
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320600000X Licence BH4801 (AZ)

Registry record

NPI
1427502947
Entity type
Organization
NPI issued
12 Aug 2016
Record last updated
12 Aug 2016

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.