Organization
FOUR DIRECTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROMUALDO R MUNOZ (PROGRAM ADMINISTRATOR)
(480) 699-2344
Entity
Organization
Contact information
Practice address
2248 N ASHBROOK CIR, MESA, AZ 85213-2276
(480) 699-2344
Mailing address
PO BOX 10908, SCOTTSDALE, AZ 85271-0908
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
CSA08ADHS0198
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSA08ADHS0198
ADHS CERTIFICATE
AZ
Enumeration date
02/14/2008
Last updated
02/14/2008
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