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Gregory Tarazon
Child Mental Illness Respite Care in Queen Creek, Arizona
NPI 1639243512

Gregory Tarazon is a Child Mental Illness Respite Care based in Queen Creek, AZ and is specialized in Respite Care, Mental Illness, Child. Gregory Tarazon practices in Queen Creek, AZ. The NPI Number for Gregory Tarazon is 1639243512 and holds a License No. 10045 (Arizona).

The current practice location address for Gregory Tarazon is 2019 W Vineyard Plains Dr, Queen Creek, AZ and can be reached out via phone at 480-655-5286.

Location: 2019 W Vineyard Plains Dr, Queen Creek, AZ, 85242-6378
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639243512
Provider Name
Gregory Tarazon
Credential
Provider Entity Type
Individual
Gender
Male
Address
2019 W Vineyard Plains Dr, Queen Creek, AZ, 85242-6378
Phone Number
480-655-5286
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
965840 01 AZ AHCCCS
institution
Provider Business Practice Location Address Details
Address
2019 W Vineyard Plains Dr
City
Queen Creek
State
Arizona
Zip
85242-6378
Phone Number
480-655-5286
Fax Number
person
Provider Business Mailing Address Details
Address
2019 W Vineyard Plains Dr
City
Queen Creek
State
Arizona
Zip
85242-6378
Phone Number
480-655-5286
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.
10045 (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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