OrganizationActive
Providence Health LLC
NPI 1184492357 · Developmentally Disabled Services Day Training Agency · Laveen, AZ
Provider details
- NPI number
- 1184492357
- Entity type
- Organization
- Primary specialty
- Developmentally Disabled Services Day Training AgencyAgencies
- Organization subpart
- No
- Authorized official
- Victory Ezenwaka, Ceo/Owner(480) 434-1113
Specialties & taxonomies
Agencies
Practice location
6311 W Magdalena Ln
Laveen, AZ 85339-5483
Phone: (480) 434-1113
Approximate (ZIP-level) locationGet directions
Mailing address
6311 W Magdalena Ln
Laveen, AZ 85339-5483
Registry dates
- Enumerated
- 2023-12-18
- Last updated
- 2023-12-18
- Certified
- 2023-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.