Organization
BLUE MOUNTAIN DEVELOPMENTAL PROGRAMS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GENEVA MELANIE WARD M.ED. (DIRECTOR)
(623) 584-5990
Entity
Organization
Contact information
Practice address
13939 W GRAND AVE, SURPRISE, AZ 85374-2440
(623) 584-5990
Mailing address
13954 W WADDELL RD STE 103, SURPRISE, AZ 85379-8751
(623) 584-5990
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
04/13/2007
Last updated
09/27/2010
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