Individual
AHMEN MCCRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2719 W GRENADINE RD, PHOENIX, AZ 85041-3426
(602) 561-4816
Mailing address
6511 W BRANHAM LN, LAVEEN, AZ 85339-2723
(602) 561-4816
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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