Organization
DANVILLE SERVICES OF ARIZONA, L.L.C.
Active
Organization
DANVILLE SERVICES OF ARIZONA, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS DANIEL PADILLA (STATE DIRECTOR)
(520) 327-9889
Entity
Organization
Contact information
Practice address
17 W WETMORE RD, #201, TUCSON, AZ 85705-1671
(520) 327-9889
(520) 320-0658
Mailing address
17 W WETMORE RD, #201, TUCSON, AZ 85705-1671
(520) 327-9889
(520) 320-0658
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
637978
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
637978
AHCCCS PROVIDER ID #
AZ
01
—
644410
AHCCCS PROVIDER ID #
AZ
Enumeration date
05/09/2007
Last updated
08/22/2020
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