Provider Demographics
NPI:1659739993
Name:CARING RESIDENTIAL SERVICES-2, LLC
Entity Type:Organization
Organization Name:CARING RESIDENTIAL SERVICES-2, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KYULULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-275-4101
Mailing Address - Street 1:6202 W SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-2536
Mailing Address - Country:US
Mailing Address - Phone:928-275-4101
Mailing Address - Fax:623-877-8992
Practice Address - Street 1:6202 W SUNNYSIDE DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-2536
Practice Address - Country:US
Practice Address - Phone:928-275-4101
Practice Address - Fax:623-877-8992
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARING RESIDENTIAL SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health