Whalio Doctors

NPI 1508233867

Golden Dream Residential Care LLC

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

Practice location

Address
621 S 115th Dr, Avondale, AZ 85323-9141
Phone
(623) 433-8189
Fax
(623) 433-9678

Authorised official

Name
William Ociti Marino
Title
Ower
Phone
(602) 299-9030

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320900000X Licence BH4619 (AZ)

Registry record

NPI
1508233867
Entity type
Organization
NPI issued
21 Aug 2015
Record last updated
21 Aug 2015

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.