Organization
KALEIDOSCOPE LLC
Active
Organization
KALEIDOSCOPE LLC
Active
Other names
Kaleidoscope Homes
Organization subpart
No
Provider details
NPI number
Authorized official
RABIYA TROTTER (ADMINISTRATOR)
(480) 504-3329
Entity
Organization
Contact information
Practice address
41288 N CAMBRIA DR, SAN TAN VALLEY, AZ 85140-3173
(480) 504-3329
Mailing address
4051 E GAIL CT, GILBERT, AZ 85296-9646
(480) 862-4855
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
163WG0000X
General Practice Registered Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5381
AZBHS
AZ
Enumeration date
04/08/2020
Last updated
04/08/2020
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