Organization
GRACELAND BEHAVIORAL HOME LLC
Active
Organization
GRACELAND BEHAVIORAL HOME LLC
Active
Other names
Graceland Behavioral Home
Organization subpart
No
Provider details
NPI number
Authorized official
KOFI OWUSU KUSI (OWNER)
(602) 752-7158
Entity
Organization
Contact information
Practice address
35696 W SANTA MONICA AVE, MARICOPA, AZ 85138-2620
(602) 752-7158
Mailing address
35696 W SANTA MONICA AVE, MARICOPA, AZ 85138-2620
(602) 752-7158
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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