Individual
CAMERON GREGORY KIRK-LUTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DSP
Contact information
Practice address
2020 E INVERNESS AVE APT 1022, MESA, AZ 85204-6972
(541) 650-2464
Mailing address
2020 E INVERNESS AVE APT 1022, MESA, AZ 85204-6972
(541) 650-2464
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
AZ
372500000X
Chore Provider
—
AZ
372600000X
Adult Companion
—
AZ
373H00000X
Day Training/Habilitation Specialist
—
AZ
3747P1801X
Personal Care Attendant
—
AZ
376J00000X
Homemaker
—
AZ
385H00000X
Respite Care
—
AZ
385HR2055X
Child Mental Illness Respite Care
—
AZ
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
AZ
385HR2065X
Child Physical Disabilities Respite Care
—
AZ
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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