Organization
MEDFORD'S HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB MEDFORD (OWNER)
(619) 708-1440
Entity
Organization
Contact information
Practice address
44276 W NEELY DR, MARICOPA, AZ 85138-9427
(619) 708-1440
Mailing address
44276 W NEELY DR, MARICOPA, AZ 85138-9427
(619) 708-1440
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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