Organization
FRIENDLY HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL ESPERICUETA (CEO)
(602) 416-7214
Entity
Organization
Contact information
Practice address
802 S 1ST AVE, PHOENIX, AZ 85003-2504
(602) 257-1870
(602) 254-3135
Mailing address
802 S 1ST AVE, P.O. BOX 3695, PHOENIX, AZ 85003-2504
(602) 257-1870
(602) 254-3135
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
461509
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
461509
AHCCCS ID
AZ
Enumeration date
11/13/2006
Last updated
07/27/2012
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