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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
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