Organization
REIGNING GRACE RANCH
Active
Organization
REIGNING GRACE RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA J MOORE (EXECUTIVE DIRECTOR)
(480) 466-2154
Entity
Organization
Contact information
Practice address
28614 N 172ND STREET, RIO VERDE, AZ 85263
(480) 466-2154
Mailing address
28150 N ALMA SCHOOL PKWY STE 103-481, SCOTTSDALE, AZ 85262-8133
(480) 466-2154
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
347C00000X
Private Vehicle
—
—
385HR2050X
Respite Care Camp
—
—
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
Update your record
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