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Amanda Ellis
Physical Disabilities Residential Treatment Facility in San Tan Valley, Arizona
NPI 1194198697

Amanda Ellis is a Physical Disabilities Residential Treatment Facility based in San Tan Valley, AZ. Amanda Ellis practices in San Tan Valley, AZ. The NPI Number for Amanda Ellis is 1194198697 and holds a License No. D05686544 (Arizona).

The current practice location address for Amanda Ellis is 381 East Brook Street, San Tan Valley, AZ and can be reached out via phone at 480-495-2839.

Location: 381 East Brook Street, San Tan Valley, AZ, 85140
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194198697
Provider Name
Amanda Ellis
Credential
Provider Entity Type
Individual
Gender
Female
Address
381 East Brook Street, San Tan Valley, AZ, 85140
Phone Number
480-495-2839
Fax Number
Provider Enumeration Date
11/05/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
381 East Brook Street
City
San Tan Valley
State
Arizona
Zip
85140
Phone Number
480-495-2839
Fax Number
person
Provider Business Mailing Address Details
Address
381 East Brook Street
City
San Tan Valley
State
Arizona
Zip
85140
Phone Number
480-495-2839
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
License No.
D05686544 (Arizona)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
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