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General NPI Number Information
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NPI Number | 1639626948
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Entity Type | Organization
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Legal Business Name | ARMS OF LOVE BEHAVIOURAL
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Dates
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Enumeration Date | 09/02/2016
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 2402 E NATHAN WAY
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City | CHANDLER
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State | AZ
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Zip | 85225-2810
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Country | US
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Telephone | 480-329-0820
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Fax |
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Provider Business Mailing Address
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Address Line | 2402 EAST NATHAN WAY
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City | CHANDLER
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State | AZ
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Zip | 85225
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Country | UM
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Telephone | 480-329-0820
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Fax |
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Authorized Official
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Title or Position | ADMISTRATOR
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Name | MISS GLADYS KWAMBOKA
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Credential | C N A
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Telephone | 480-329-0820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 1000028929
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License Number State | AZ
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