Individual provider · Type 1 NPI
Amanda Ellis
Physical Disabilities Residential Treatment Facility · San Tan Valley, AZ
NPI number
1194198697
Active
Practice location
381 East Brook Street
San Tan Valley, AZ 85140
Mailing address
381 E Brook St
San Tan Valley, AZ 85140
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Disabilities Residential Treatment Facility Primary | 320700000X | D05686544 (AZ) |
Physical Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
About NPI 1194198697
Amanda Ellis's National Provider Identifier is 1194198697, issued on Nov 5, 2015. The primary taxonomy on file is Physical Disabilities Residential Treatment Facility (320700000X), and the practice location is in San Tan Valley, AZ. The record was last updated on Nov 5, 2015.