Individual
STEVEN ILLERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
8122828
AZ
385HR2055X
Child Mental Illness Respite Care
8122828
AZ
Other
Enumeration date
11/30/2016
Last updated
02/04/2021
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