Organization
FERVENT CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCKY IDA IGBINOBA (CEO)
(763) 723-1475
Entity
Organization
Contact information
Practice address
4225 E UNIVERSITY DR APT 107, MESA, AZ 85205-7092
(763) 923-1475
Mailing address
4225 E UNIVERSITY DR APT 107, MESA, AZ 85205-7092
(763) 923-1475
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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