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Fred Miranda
Child Mental Illness Respite Care in Phoenix, Arizona
NPI 1669546610

Fred Miranda is a Child Mental Illness Respite Care based in Phoenix, AZ and is specialized in Respite Care, Mental Illness, Child. Fred Miranda practices in Phoenix, AZ. The NPI Number for Fred Miranda is 1669546610 and holds a License No. 3856 (Arizona).

The current practice location address for Fred Miranda is 4044 W Hadley St, Phoenix, AZ and can be reached out via phone at 602-272-1213.

Location: 4044 W Hadley St, Phoenix, AZ, 85009-5310
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669546610
Provider Name
Fred Miranda
Credential
Provider Entity Type
Individual
Gender
Male
Address
4044 W Hadley St, Phoenix, AZ, 85009-5310
Phone Number
602-272-1213
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
AHCCCS 01 AZ 729725
institution
Provider Business Practice Location Address Details
Address
4044 W Hadley St
City
Phoenix
State
Arizona
Zip
85009-5310
Phone Number
602-272-1213
Fax Number
person
Provider Business Mailing Address Details
Address
4044 W Hadley St
City
Phoenix
State
Arizona
Zip
85009-5310
Phone Number
602-272-1213
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.
3856 (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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