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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