# DW DEVELOPMENTAL HOMES LLC

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

## Provider details

- **NPI number:** 1467198010
- **Authorized official:** SIMONA SHALLESE WILFRED (CEO)
- **Authorized official phone:** (951) 377-2710

## Contact information

- **Practice address:** 2609 NORTH 107TH AVE, AVONDALE, AZ 85353
- **Practice address phone:** (951) 377-2710
- **Mailing address:** 9035 W GLOBE AVE, TOLLESON, AZ 85353-8642
- **Mailing address phone:** (951) 377-2710

## Taxonomy

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

## Other

- **Enumeration date:** 05/06/2022
- **Last updated:** 05/06/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00000000 | — | AZ |