Organization
A MOTHERS LOVE RESIDENTIAL HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY MILLER (CHIEF EXECECUTIVE OFFICER)
(623) 792-5336
Entity
Organization
Contact information
Practice address
11610 W WINDROSE AVE, EL MIRAGE, AZ 85335-3951
(623) 792-5336
(602) 926-8174
Mailing address
11610 W WINDROSE AVE, EL MIRAGE, AZ 85335-3951
(623) 792-5336
(602) 926-8174
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH4352
AZ
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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