Organization
BLUE DRAGONFLY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA LYNN WOODWARD (CEO/FOUNDER)
(480) 347-0738
Entity
Organization
Contact information
Practice address
654 W PLATA AVE, MESA, AZ 85210-8331
(480) 347-0738
Mailing address
654 W PLATA AVE, MESA, AZ 85210-8331
(480) 347-0738
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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