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Shanney Shonttile Porter
Child Mental Illness Respite Care in Phoenix, Arizona
NPI 1326232885

Shanney Shonttile Porter is a Child Mental Illness Respite Care based in Phoenix, AZ and is specialized in Respite Care, Mental Illness, Child. Shanney Shonttile Porter practices in Phoenix, AZ. The NPI Number for Shanney Shonttile Porter is 1326232885 and holds a License No. 209618 (Arizona).

The current practice location address for Shanney Shonttile Porter is 4011 W Surrey Ave, Phoenix, AZ and can be reached out via phone at 602-298-6987. You can also correspond with Shanney Shonttile Porter through the mailing address at 4011 W SURREY AVE, PHOENIX, AZ - 85029-1949 (mailing address contact number: 602-298-6987).

Location: 4011 W Surrey Ave, Phoenix, AZ, 85029-1949
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1326232885
Provider Name
Shanney Shonttile Porter
Credential
Provider Entity Type
Individual
Gender
Male
Address
4011 W Surrey Ave, Phoenix, AZ, 85029-1949
Phone Number
602-298-6987
Fax Number
Provider Enumeration Date
08/28/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4011 W Surrey Ave
City
Phoenix
State
Arizona
Zip
85029-1949
Phone Number
602-298-6987
Fax Number
person
Provider Business Mailing Address Details
Address
4011 W Surrey Ave
City
Phoenix
State
Arizona
Zip
85029-1949
Phone Number
602-298-6987
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.
209618 (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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