Individual
HOWARD L THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BH8703
Contact information
Practice address
5528 W MALDONADO RD, LAVEEN, AZ 85339-4211
(919) 824-6953
Mailing address
5528 W MALDONADO RD, LAVEEN, AZ 85339-4211
(919) 824-6953
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
BH8703
AZ
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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