Organization
BROTHERS AND KEEPERS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC EDWARD DOMINGUEZ JR. (PROGRAM DIRECTOR)
(909) 223-1939
Entity
Organization
Contact information
Practice address
3947 W KIRKLAND AVE, SAN TAN VALLEY, AZ 85142-6836
(480) 630-9933
Mailing address
2200 E WILLIAMS FIELD RD STE 200, GILBERT, AZ 85295-0764
(480) 630-9933
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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