Organization
PRESIDENTIAL MANSIONCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNEDY ABBA KEDAY AMUGHAN BHT (EXECUTIVE DIRECTOR)
(623) 202-9583
Entity
Organization
Contact information
Practice address
18428 W MIAMI ST, GOODYEAR, AZ 85338-7490
(623) 202-9583
(623) 882-0715
Mailing address
1647 S 170TH AVE, GOODYEAR, AZ 85338-7324
(623) 202-9583
(623) 215-2212
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
BH2753
AZ
Other
Enumeration date
07/02/2015
Last updated
12/11/2023
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