Organization
MISS A'S LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISA DENEKE (ADMINISTRATOR)
(623) 670-0039
Entity
Organization
Contact information
Practice address
9143 N 82ND LN, PEORIA, AZ 85345-4827
(623) 670-0039
(623) 399-1437
Mailing address
5421 W DESERT HILLS DR, GLENDALE, AZ 85304-2703
(623) 670-0039
(623) 399-1437
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222757
—
AZ
Enumeration date
03/06/2020
Last updated
03/06/2020
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