Organization
ZAHRA C. M. PLAGENS
Active
Other names
Mutwol Family Adult Therapeutic Foster Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZAHRA CHEBET PLAGENS (ADMINISTRATOR)
(623) 878-0463
Entity
Organization
Contact information
Practice address
7445 W CHERYL DR, PEORIA, AZ 85345-6722
(623) 878-0463
Mailing address
7445 W CHERYL DR, PEORIA, AZ 85345-6722
(623) 878-0463
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
BH2522
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
907305
—
AZ
01
—
BH2522
STATE LICENSE FOSTER CARE
AZ
Enumeration date
01/22/2007
Last updated
09/17/2008
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