Organization
WILLIAMS SUDAN GUEST HOMES
Active
Other names
Gleneagle Residential Care & Adult Day Treatment Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EVELYN WILLLLIAMS (CLINICAL DIRECTOR)
(480) 751-7483
Entity
Organization
Contact information
Practice address
15111 E VIA DE OLIVOS RD, CHANDLER, AZ 85249-7423
(480) 751-7483
(480) 895-8399
Mailing address
4133 EAST GLENAGELE DR, CHANDLER, AZ 85249-7423
(480) 751-7483
(480) 895-8399
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
BH-3215
AZ
251S00000X
Community/Behavioral Health Agency
BH-3215
AZ
261QM0850X
Adult Mental Health Clinic/Center
BH-3215
AZ
261QM2800X
Methadone Clinic
BBH-3215
AZ
261QP2000X
Physical Therapy Clinic/Center
BH-3215
AZ
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
BH-3215
AZ
261QX0100X
Occupational Medicine Clinic/Center
BH-3215
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
BH-3215
AZ
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
BH-3215
AZ
3245S0500X
Children's Substance Abuse Rehabilitation Facility
BH-3215
AZ
347C00000X
Private Vehicle
BH-3215
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
438547
—
AZ
Enumeration date
07/21/2009
Last updated
07/21/2009
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