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Kenny Jacobs
Child Mental Illness Respite Care in Phoenix, Arizona
NPI 1447324397

Kenny Jacobs is a Child Mental Illness Respite Care based in Phoenix, AZ and is specialized in Respite Care, Mental Illness, Child. Kenny Jacobs practices in Phoenix, AZ. The NPI Number for Kenny Jacobs is 1447324397 and holds a License No. 10730 (Arizona).

The current practice location address for Kenny Jacobs is 8010 W Hilton Ave, Phoenix, AZ and can be reached out via phone at 623-322-5288.

Location: 8010 W Hilton Ave, Phoenix, AZ, 85043-7420
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1447324397
Provider Name
Kenny Jacobs
Credential
Provider Entity Type
Individual
Gender
Male
Address
8010 W Hilton Ave, Phoenix, AZ, 85043-7420
Phone Number
623-322-5288
Fax Number
Provider Enumeration Date
11/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
113609 01 AZ AHCCCS ID NUMBER
institution
Provider Business Practice Location Address Details
Address
8010 W Hilton Ave
City
Phoenix
State
Arizona
Zip
85043-7420
Phone Number
623-322-5288
Fax Number
person
Provider Business Mailing Address Details
Address
8010 W Hilton Ave
City
Phoenix
State
Arizona
Zip
85043-7420
Phone Number
623-322-5288
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.
10730 (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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