Provider Demographics
NPI:1255667713
Name:VALLEYLIFE
Entity Type:Organization
Organization Name:VALLEYLIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS-REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-371-0806
Mailing Address - Street 1:1142 W HATCHER RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-3045
Mailing Address - Country:US
Mailing Address - Phone:602-371-0806
Mailing Address - Fax:602-944-8749
Practice Address - Street 1:1502 W MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2158
Practice Address - Country:US
Practice Address - Phone:602-371-0806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services