Organization
FENIX GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON TILLEY (CEO)
(623) 882-2016
Entity
Organization
Contact information
Practice address
919 N DYSART RD, STE V, AVONDALE, AZ 85323-1711
(623) 882-2016
Mailing address
919 N DYSART RD, STE V, AVONDALE, AZ 85323-1711
(623) 882-2016
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
06262
AZ
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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