Individual
MR. JOSE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10348 W RAYMOND ST, TOLLESON, AZ 85353-7639
(602) 348-8857
Mailing address
10348 W RAYMOND ST, TOLLESON, AZ 85353-7639
(602) 348-8857
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
2000704
AZ
3747P1801X
Personal Care Attendant
—
—
385HR2055X
Child Mental Illness Respite Care
2000704
AZ
Other
Enumeration date
03/21/2012
Last updated
09/26/2022
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