Organization
DEVEREUX FOSTER CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA ZAMBRANO (FOSTER PARENT)
(623) 979-1150
Entity
Organization
Contact information
Practice address
5603 W SHANGRI LA RD, GLENDALE, AZ 85304-3851
(623) 979-1150
Mailing address
5603 W SHANGRI LA RD, GLENDALE, AZ 85304-3851
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
11355
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116658
AHCCCS ID NUMBER
AZ
Enumeration date
11/29/2006
Last updated
08/22/2020
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