Individual
LYDDIA GETAWERU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA, LNHA, ALM
Contact information
Practice address
2767 W PEGGY DR, QUEEN CREEK, AZ 85142-6686
(480) 656-5357
Mailing address
2767 W PEGGY DR, QUEEN CREEK, AZ 85142-6686
(480) 656-5357
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH6339
AZ
323P00000X
Psychiatric Residential Treatment Facility
BH6339
AZ
347E00000X
Transportation Broker
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH6339
—
AZ
Enumeration date
08/05/2020
Last updated
03/09/2021
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