Organization
DED ENTERPRISES ENTERTAINMENT
Active
Other names
David Evan Den Fouw
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID EVAN DEN BOER M.S., B.S. (PRESIDENT)
(602) 354-1337
Entity
Organization
Contact information
Practice address
901 S COUNTRY CLUB DR APT 2148, MESA, AZ 85210-3590
(602) 354-1337
Mailing address
901 S COUNTRY CLUB DR APT 2148, MESA, AZ 85210-3590
(602) 354-1337
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
D07408423
AZ
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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