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General NPI Number Information
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NPI Number | 1184186355
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Entity Type | Organization
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Legal Business Name | COMFORT CARE CELTIC HOMES
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 04/04/2019
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Provider Practice Location Address
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Address Line | 22509 N CELTIC AVE
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City | MARICOPA
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State | AZ
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Zip | 85139-8899
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Country | US
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Telephone | 520-213-8342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2382
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City | CHANDLER
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State | AZ
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Zip | 85244-2382
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ABDILATIF KASSIM
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Credential |
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Telephone | 602-323-4616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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