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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSEMARIE GESSING (SLP-A)
(602) 767-2875
Entity
Organization

Contact information

Practice address
20033 N 19TH AVE STE 121, PHOENIX, AZ 85027-4251
(602) 875-5616
(480) 666-0625
Mailing address
15219 S 13TH WAY, PHOENIX, AZ 85048-6204
(602) 767-2875

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
SLPA8835
AZ

Other

Enumeration date
06/05/2014
Last updated
08/26/2022
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