Organization
FAMILY SUPPORT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINGSLEY S OKYERE (MD)
(614) 286-8511
Entity
Organization
Contact information
Practice address
1209 W BOSTON ST, CHANDLER, AZ 85224-6168
(614) 286-8511
(614) 416-2091
Mailing address
1209 W BOSTON ST, CHANDLER, AZ 85224-6168
(614) 286-8511
(614) 416-2091
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
BH-3567
AZ
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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