Organization
SUPABILINGUALTHERAPYSERVICES.LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARVAH D'AQUINO (OWNER)
(623) 237-1922
Entity
Organization
Contact information
Practice address
2615 N CHAMPLAIN AVE, TEMPE, AZ 85281-7905
(623) 237-1922
Mailing address
2615 N CHAMPLAIN AVE, TEMPE, AZ 85281-7905
(623) 237-1922
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639449010
PT, OT,ST
AZ
Enumeration date
01/03/2012
Last updated
11/29/2012
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