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General NPI Number Information
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NPI Number | 1730395757
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Entity Type | Organization
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Legal Business Name | DARIENNE, LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 2150 S 1ST AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-2204
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Country | US
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Telephone | 928-348-3293
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 S 1ST AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-2204
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Country | US
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Telephone | 928-348-3293
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LA WYNN BROWN
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Credential | PT
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Telephone | 928-428-0280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1710
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ADH6049
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License Number State | AZ
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