Arizona Alternative Support, LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Maricopa, AZ

NPI 1265050876 · NPPES record last updated Jul 9, 2020

Key facts

NPI
1265050876
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
ARIZONA ALTERNATIVE SUPPORT, LLC
Practice address
36379 W El Greco St
Maricopa, AZ 85138-5323
Phone
(774) 253-7365
NPI assigned
Jul 9, 2020
Organization subpart
No

Authorized official

Name
Mrs. Irene N Mulondo, RN, BSN
Title
Administrator
Phone
(774) 253-7365

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Arizona Alternative Support LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

36379 W El Greco St
Maricopa, AZ 85138-5323

Mailing address

621 S Wayne Dr
Chandler, AZ 85225-2817
Phone (774) 253-7365

Other providers in Maricopa, AZ

All providers in Maricopa, AZ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arizona

Sources for this page

Verify at the official NPI Registry.