Provider Demographics
NPI:1639626948
Name:ARMS OF LOVE BEHAVIOURAL
Entity Type:Organization
Organization Name:ARMS OF LOVE BEHAVIOURAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAMBOKA
Authorized Official - Suffix:
Authorized Official - Credentials:C N A
Authorized Official - Phone:480-329-0820
Mailing Address - Street 1:2402 EAST NATHAN WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225
Mailing Address - Country:UM
Mailing Address - Phone:480-329-0820
Mailing Address - Fax:
Practice Address - Street 1:2402 E NATHAN WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2810
Practice Address - Country:US
Practice Address - Phone:480-329-0820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1000028929376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty