Organization
FAMILY HOME LLC
Active
Other names
Family Home LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MOJOK AJAWIN (MANAGER/OWNER)
(480) 358-7850
Entity
Organization
Contact information
Practice address
10423 W EDGEMONT DR, AVONDALE, AZ 85392-4652
(480) 358-7850
Mailing address
6035 W KRISTAL WAY, GLENDALE, AZ 85308-7802
(480) 358-7850
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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