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General NPI Number Information
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NPI Number | 1902523244
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Entity Type | Organization
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Legal Business Name | ADORE GROUP HOMES L.L.C
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 12457 W KALER DR APT 257
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City | GLENDALE
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State | AZ
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Zip | 85307-1782
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Country | US
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Telephone | 404-573-2558
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Fax |
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Provider Business Mailing Address
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Address Line | 14221 N 51ST AVE APT 1183
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City | GLENDALE
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State | AZ
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Zip | 85306-2546
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Country | US
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Telephone | 404-573-2558
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FATMATA SANNOH
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Credential |
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Telephone | 404-573-2558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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