Organization
NGALLE HOMES CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY NGALLE MD (CEO)
(480) 687-5301
Entity
Organization
Contact information
Practice address
721 E FORGE AVE, MESA, AZ 85204-4916
(602) 775-0609
(480) 687-5301
Mailing address
721 E FORGE AVE, MESA, AZ 85204-4916
(602) 775-0609
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
10/04/2022
Last updated
11/07/2022
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