Organization
THE WATKINS HOME
Active
Other names
The Watkins Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YVONNE ANN WATKINS (ADMINISTRATOR)
(623) 535-5533
Entity
Organization
Contact information
Practice address
15372 W ROANOKE AVE, GOODYEAR, AZ 85395-8980
(623) 535-5533
(623) 535-6666
Mailing address
15372 W ROANOKE AVE, GOODYEAR, AZ 85395-8980
(623) 535-5533
(623) 535-6666
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
BH4267
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
941147
—
AZ
01
—
BH2622
OBHL LICENSE
AZ
01
—
BH3584
OFFICE OF BEHAVIORAL HEALTH LICENSE NUMBER
AZ
Enumeration date
01/25/2007
Last updated
06/12/2013
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