Whalio Doctors

NPI 1700423902

Randy Bland

Practitioner Child Mental Illness Respite Care Goodyear, AZ

Practice location

Address
14047 W Monte Vista Rd, Goodyear, AZ 85395
Phone
(480) 334-2092
Mailing address
Intermountain Centers for Human Development INC. PO Box 86537, Tucson, AZ 85754-6537

Registered specialties

Child Mental Illness Respite Care Primary
Respite Care Facility Taxonomy 385HR2055X Licence 10126301 (AZ)

Registry record

NPI
1700423902
Entity type
Individual
Sex (as registered)
Male
NPI issued
6 Dec 2019
Record last updated
29 Jun 2021

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.