MEDICARE: UYI DEVELOPMENTAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	B2361 B2362	AZ

General Provider Information

NPI Number	:	1134276082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UYI DEVELOPMENTAL CENTER

Provider Business Mailing Address
First Line	:	5270 N 59TH AVE STE 11
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-6764
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5270 N 59TH AVE STE 11
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-6764
Country	:	US
Telephone Number	:	623-847-9800
Fax Number	:	623-934-5360

Authorized Official
Title or Position	:	CEO
Name	:	MR. RICHARD A AYIYI SR.
Credential	:	BS
Telephone Number	:	602-301-0214

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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Directions to “UYI DEVELOPMENTAL CENTER ” Practice Location

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