Organization
KIDDES CROWNED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEE LAUREN KIDDE (OWNER)
(602) 571-8563
Entity
Organization
Contact information
Practice address
44408 W PALO ALISO WAY, MARICOPA, AZ 85138-3467
(602) 571-8563
Mailing address
1301 N CENTRAL AVE SUITE 183, PHOENIX, AZ 85012
(602) 571-8563
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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