Organization
THE EAGLE WATCH BHS QUINTANA
Active
Parent organization
THE EAGLE WATCH BHS LLC
Other names
Quintana
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE EAGLE WATCH BHS LLC
Authorized official
MR. JOHN M KAMAU ADMIN (ADMINISTRATOR)
(602) 369-2609
Entity
Organization
Contact information
Practice address
4145 E MEGAN ST, GILBERT, AZ 85295-7736
(602) 369-2609
(480) 207-1420
Mailing address
4145 E MEGAN ST, GILBERT, AZ 85295-7736
(602) 369-2609
(480) 207-1420
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
BH4705
AZ
Other
Enumeration date
04/18/2016
Last updated
05/26/2016
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