Organization
REY ASH RESIDENTIAL FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMMANUEL ASHIAGBOR (ADMINISTRATOR/OWNER)
(602) 214-2279
Entity
Organization
Contact information
Practice address
3765 W YELLOW PEAK DR, SAN TAN VALLEY, AZ 85142-3090
(602) 214-2279
Mailing address
3765 W YELLOW PEAK DR, SAN TAN VALLEY, AZ 85142-3090
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH5210
—
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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