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Organization
NEVAEH'S LLC
Active
Organization
NEVAEH'S LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEE'ANNA MARIE SMALLWOOD (CHIEF ADMINISTION OFFICER)
(602) 413-4412
Entity
Organization
Contact information
Practice address
403 W HARWELL RD, PHOENIX, AZ 85041-8034
(602) 441-3050
Mailing address
403 W HARWELL RD, PHOENIX, AZ 85041-8034
(602) 441-3050
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-3374
AZ
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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