Organization
JADEM ARK OF HOPE, LLC
Active
Other names
JADEM Care Network
Organization subpart
No
Provider details
NPI number
Authorized official
MERCY NKENGAWUNG NKEZE PHARMD (CHIEF ORGANIZATION)
(206) 334-3511
Entity
Organization
Contact information
Practice address
1214 E FAIRMONT DR, TEMPE, AZ 85282-3938
(480) 284-5590
Mailing address
10370 W ODEUM LN, TOLLESON, AZ 85353-4194
(206) 334-3511
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131381
—
AZ
Enumeration date
05/19/2023
Last updated
05/19/2023
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