Organization
ARIZONA CHILDREN HOME,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY B. UDOINWANG (PRESIDENT/CEO)
(602) 757-4861
Entity
Organization
Contact information
Practice address
9403 W SHERIDAN ST, PHOENIX, AZ 85037-4338
(623) 388-3458
(623) 388-6948
Mailing address
PO BOX 14392, PHOENIX, AZ 85063-4392
(623) 388-3458
(623) 388-6948
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
BH4454
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH4454
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
08/14/2014
Last updated
08/14/2014
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