Individual
IDRIS ROBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4494 W PEORIA AVE STE 101, GLENDALE, AZ 85302-2024
(602) 687-2043
(623) 440-4285
Mailing address
4494 W PEORIA AVE STE 101, GLENDALE, AZ 85302-2024
(602) 687-2043
(623) 440-4285
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
221509-14979
AZ
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us