Individual
BRANDI ANN JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7576 W DARREL RD, LAVEEN, AZ 85339-7086
(623) 296-4535
Mailing address
7576 W DARREL RD, LAVEEN, AZ 85339-7086
(623) 296-4535
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH10482
AZ
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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