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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