Organization
RED MOUNTAIN RESPITE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROMUALDO R MUNOZ (CHIEF ADMINISTRATIVE OFFICER)
(480) 641-9552
Entity
Organization
Contact information
Practice address
1329 S ROSEANN, MESA, AZ 85209-3739
(480) 641-9552
(480) 981-0893
Mailing address
1223 S CLEARVIEW AVE STE 109, MESA, AZ 85209-3306
(480) 641-9552
(480) 981-0893
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
CSA05ADHS0180
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0093862302
—
AZ
Enumeration date
09/08/2006
Last updated
08/22/2020
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