# AZ INTERACT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427502947
- **Authorized official:** EDUARDO SANTANA (SUPERVISOR)
- **Authorized official phone:** (602) 487-8806

## Contact information

- **Practice address:** 6055 WEST CARIBE LANE, GLENDALE, AZ 85306
- **Practice address phone:** (602) 487-8806
- **Mailing address:** 2325 W DESPERADO WAY, PHOENIX, AZ 85085-5777
- **Mailing address phone:** (602) 487-8806

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | BH4514 | AZ | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | BH4801 | AZ | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | BH4802 | AZ | — |

## Other

- **Enumeration date:** 08/12/2016
- **Last updated:** 08/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1154781037 | — | AZ |
| 05 | — | 1518327493 | — | AZ |
| 05 | — | 1760885347 | — | AZ |