Organization
BURNES WEST HOME
Active
Other names
Burnes West Home
Organization subpart
No
Provider details
NPI number
Authorized official
JARED ANTHONY GRIFFIN (SPONSOR)
(480) 857-0047
Entity
Organization
Contact information
Practice address
15266 N 145TH LN, SURPRISE, AZ 85379-8519
(480) 857-0047
Mailing address
15266 N 145TH LN, SURPRISE, AZ 85379-8519
(480) 857-0047
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
BH3369
AZ
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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