Organization
AMAZING GRACE ARIZONA FOUNDATION
Active
Organization
AMAZING GRACE ARIZONA FOUNDATION
Active
Other names
Amazing Grace Ranch Az
Organization subpart
No
Provider details
NPI number
Authorized official
SHELAIRE SPEARS (DIRECTOR)
(404) 528-3338
Entity
Organization
Contact information
Practice address
8252 S 15TH AVE, PHOENIX, AZ 85041-7806
(480) 232-6978
Mailing address
1820 E LOCKWOOD ST, MESA, AZ 85203-2106
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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