Organization
THE WATKINS HOME
Active
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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