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General NPI Number Information
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NPI Number | 1720865009
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Entity Type | Organization
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Legal Business Name | MAIS-A-MAIS LLC
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 1221 E BROADWAY RD APT 2017
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City | TEMPE
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State | AZ
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Zip | 85282-1079
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Country | US
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Telephone | 602-632-2562
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Fax |
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Provider Business Mailing Address
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Address Line | 5427 W BOWKER ST
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City | LAVEEN
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State | AZ
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Zip | 85339-1512
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Country | US
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Telephone | 602-384-3378
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JANE SABUNI
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Credential |
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Telephone | 602-632-2562
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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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