Daniel Granthan

Individual provider Active NPI Child Mental Illness Respite Care · Arivaca, AZ

NPI 1992967988 · NPPES record last updated Jun 30, 2008

Key facts

NPI
1992967988
Entity type
Individual (NPI type 1)
Primary specialty
Child Mental Illness Respite Care 385HR2055X
License
8637 (AZ)
Practice address
14500 Crooked Skya
Arivaca, AZ 85601-0264
Phone
(520) 398-9151
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8637AZMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 8637 AZ Yes

Addresses

Primary practice location

14500 Crooked Skya
Arivaca, AZ 85601-0264

Mailing address

PO Box 264
Arivaca, AZ 85601-0264
Phone (520) 398-9151

Other providers in Arivaca, AZ

All providers in Arivaca, AZ · Child Mental Illness Respite Care in Arizona

Sources for this page

Verify at the official NPI Registry.