Organization
CHRISTIAN FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA BETH GOMEZ (PROFESSIONAL FOSTER PARENT)
(602) 299-5965
Entity
Organization
Contact information
Practice address
15415 N 45TH ST, PHOENIX, AZ 85032-4242
(602) 299-5965
Mailing address
15415 N 45TH ST, PHOENIX, AZ 85032-4242
(602) 299-5965
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
11078
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158115
THERAPEUTIC FOSTER CARE
AZ
Enumeration date
03/06/2007
Last updated
06/27/2008
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