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
National Provider Directory
- Tax ID family
- Arizona Alternative Support LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Maricopa, AZ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.