Organization
YAJCINLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWADWO KANTANKA (ADMINISTRATOR/CEO)
(480) 393-0662
Entity
Organization
Contact information
Practice address
1609 E HEATHER DR, QUEEN CREEK, AZ 85240-5682
(480) 393-0662
(602) 283-3476
Mailing address
1609 E HEATHER DR, QUEEN CREEK, AZ 85240-5682
(480) 393-0662
(602) 283-3476
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-3086
AZ
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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