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Organization
WELL FIT BEHAVIOR LLC
Active
Organization
WELL FIT BEHAVIOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLOIRE DEPARDIEU MOUGANI CNA (OWNER)
(614) 772-8182
Entity
Organization
Contact information
Practice address
25843 W SHANGRA LA, CASA GRANDE, AZ 85193-7525
(478) 420-0060
Mailing address
25843 W SHANGRA LA, CASA GRANDE, AZ 85193-7525
(478) 420-0060
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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