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Ms. Juanita Davis
Child Mental Illness Respite Care in Phoenix, Arizona
NPI 1053487330

Juanita Davis is a Child Mental Illness Respite Care based in Phoenix, AZ and is specialized in Respite Care, Mental Illness, Child. Juanita Davis practices in Phoenix, AZ. The NPI Number for Juanita Davis is 1053487330 and holds a License No. 10729 (Arizona).

The current practice location address for Juanita Davis is 3444 E Melody Dr, Phoenix, AZ and can be reached out via phone at 602-454-9440.

Location: 3444 E Melody Dr, Phoenix, AZ, 85042-7265
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053487330
Provider Name
Juanita Davis
Credential
Provider Entity Type
Individual
Gender
Female
Address
3444 E Melody Dr, Phoenix, AZ, 85042-7265
Phone Number
602-454-9440
Fax Number
Provider Enumeration Date
11/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
112538 01 AZ AHCCCS ID NUMBER
institution
Provider Business Practice Location Address Details
Address
3444 E Melody Dr
City
Phoenix
State
Arizona
Zip
85042-7265
Phone Number
602-454-9440
Fax Number
person
Provider Business Mailing Address Details
Address
3444 E Melody Dr
City
Phoenix
State
Arizona
Zip
85042-7265
Phone Number
602-454-9440
Fax Number
person
Provider's Taxonomy Details 1
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Mental Illness, Child
Taxonomy
385HR2055X
License No.
10729 (Arizona)
Definition
A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers.
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