Individual
WILLIAM GENE BIBBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 WISHING WELL DR, MEADVIEW, AZ 86444-0729
(484) 824-3068
Mailing address
PO BOX 729, MEADVIEW, AZ 86444-0729
(484) 824-3068
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1747326
AZ
3747P1801X
Personal Care Attendant
—
—
385HR2055X
Child Mental Illness Respite Care
1747326
AZ
Other
Enumeration date
11/07/2012
Last updated
02/03/2021
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