Provider Demographics
NPI:1629485180
Name:EAST VALLEY ADULT RESOURCES
Entity Type:Organization
Organization Name:EAST VALLEY ADULT RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:480-964-9014
Mailing Address - Street 1:45 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-5831
Mailing Address - Country:US
Mailing Address - Phone:480-964-9014
Mailing Address - Fax:480-898-7306
Practice Address - Street 1:45 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5831
Practice Address - Country:US
Practice Address - Phone:480-964-9014
Practice Address - Fax:480-898-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable