Organization
ANGELIC PEACE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEACE C EZEOGBA (DIRECTOR)
(623) 633-9079
Entity
Organization
Contact information
Practice address
2344 N ALSAP RD, BUCKEYE, AZ 85396-1664
(623) 633-9079
Mailing address
2344 N ALSAP RD, BUCKEYE, AZ 85396-1664
(623) 633-9079
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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