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General NPI Number Information
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NPI Number | 1134095573
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Entity Type | Organization
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Legal Business Name | GODS ONLY CHOICE CITY OF REFUGE INC
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 8910 W MONROE ST
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City | PEORIA
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State | AZ
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Zip | 85345-6440
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Country | US
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Telephone | 480-788-4557
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Fax |
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Provider Business Mailing Address
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Address Line | 3342 S 257TH DR # 663607
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City | BUCKEYE
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State | AZ
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Zip | 85326-1832
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Country | US
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Telephone | 480-788-4557
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | CHARLETTE DANYELLE ONLY-GRANT
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Credential |
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Telephone | 708-265-4447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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