Organization
DESMALE SOCIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL OGHENJABOR (PROGRAM DIRECTOR)
(623) 444-2731
Entity
Organization
Contact information
Practice address
12818 W SOLEDAD ST, EL MIRAGE, AZ 85335-8229
(623) 444-2731
(623) 444-4099
Mailing address
12818 W SOLEDAD ST, EL MIRAGE, AZ 85335-8229
(623) 444-2731
(623) 444-4099
Taxonomy
Speciality
Code
Description
License number
State
385HR2065X
Child Physical Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
393765
—
AZ
Enumeration date
11/16/2010
Last updated
11/16/2010
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