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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