Healthcare Provider Details

I. General information

NPI: 1992486963
Provider Name (Legal Business Name): ARIZONA DEVELOPMENTAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 W CAMELBACK RD
PHOENIX AZ
85015-3441
US

IV. Provider business mailing address

2040 W CAMELBACK RD
PHOENIX AZ
85015-3441
US

V. Phone/Fax

Practice location:
  • Phone: 602-296-5781
  • Fax:
Mailing address:
  • Phone: 602-296-5781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHELBEY ENGLAND
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 602-296-5781