Organization
VILLAGE MENTORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERMAINE JORDAN MBA (CEO)
(480) 313-4770
Entity
Organization
Contact information
Practice address
4903 E DIXON CIR, MESA, AZ 85205-6453
(480) 313-4770
Mailing address
4903 E DIXON CIR, MESA, AZ 85205-6453
(480) 313-4770
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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