Individual
LETRICE NICOLE GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24117 N MOJAVE LN, FLORENCE, AZ 85132-5209
(520) 518-1757
Mailing address
24117 N MOJAVE LN, FLORENCE, AZ 85132-5209
(520) 518-1757
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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