# DESERT AGAVE HOMES LLC

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

## Provider details

- **NPI number:** 1780275537
- **Authorized official:** MADISON SHAUN BROWN (OWNER)
- **Authorized official phone:** (646) 460-1913

## Contact information

- **Practice address:** 810 S 124TH AVE, AVONDALE, AZ 85323-8490
- **Practice address phone:** (623) 242-7962
- **Mailing address:** 3403 E DIAMOND AVE, MESA, AZ 85204-4017
- **Mailing address phone:** (646) 460-1913

## Taxonomy

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

## Other

- **Enumeration date:** 02/03/2021
- **Last updated:** 02/03/2021