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General NPI Number Information
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NPI Number | 1538523246
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Entity Type | Organization
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Legal Business Name | JOECHRIS HOME LLC.
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 44349 W BAILEY DR
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City | MARICOPA
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State | AZ
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Zip | 85138-6406
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Country | US
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Telephone | 520-413-0905
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Fax |
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Provider Business Mailing Address
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Address Line | 44349 W BAILEY DR
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City | MARICOPA
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State | AZ
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Zip | 85138-6406
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Country | US
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Telephone | 520-413-0905
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOSEPH NJUGUNA
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Credential |
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Telephone | 480-406-2545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | LP048680
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License Number State | AZ
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