IndividualActive
Amanda Ellis
NPI 1194198697 · Physical Disabilities Residential Treatment Facility · San Tan Valley, AZ
Provider details
- NPI number
- 1194198697
- Entity type
- Individual
- Primary specialty
- Physical Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- D05686544 (AZ)
Practice location
381 East Brook Street
San Tan Valley, AZ 85140
Phone: (480) 495-2839
Mailing address
381 E Brook St
San Tan Valley, AZ 85140
Registry dates
- Enumerated
- 2015-11-05
- Last updated
- 2015-11-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.