Provider Demographics
NPI:1952855736
Name:CERTITUDE GROUP LLC
Entity Type:Organization
Organization Name:CERTITUDE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDALEN
Authorized Official - Middle Name:JAE
Authorized Official - Last Name:KRENZELOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-540-4130
Mailing Address - Street 1:9319 W HATCHER RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6312
Mailing Address - Country:US
Mailing Address - Phone:602-301-9447
Mailing Address - Fax:
Practice Address - Street 1:8155 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4159
Practice Address - Country:US
Practice Address - Phone:480-540-4130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services