Organization
POTTERS PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARDELL C DANIELS (ASSISTANT EXECUTIVE OFFICER)
(623) 848-0629
Entity
Organization
Contact information
Practice address
8629 W ROANOKE AVE, PHOENIX, AZ 85037-3519
(623) 848-0629
(623) 873-6127
Mailing address
8629 W ROANOKE AVE, PHOENIX, AZ 85037-3519
(623) 848-0629
(623) 873-6127
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH3284
AZ
Other
Enumeration date
12/07/2009
Last updated
12/07/2009
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