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4 A Health Care LLC

Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Phoenix, AZ. Organization (NPI-2).

NPI number1689293177
StatusActive
Last updated in NPPESApr 14, 2020

Details

NPI
1689293177
Entity type
Organization (NPI-2)
Legal business name
4 A Health Care LLC
Organization subpart
No
Enumeration date
Apr 14, 2020
Certification date
Apr 14, 2020
Last updated
Apr 14, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities––Yes

Practice location

8330 N 19th Ave Apt 2095
Phoenix, AZ 85021-5277

Phone 480-200-2033

Mailing address

8330 N 19th Ave Apt 2095
Phoenix, AZ 85021-5277

Authorized official

Solomon Anthony
Owner
4802002033

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