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Gwendolyn Baker
Child Mental Illness Respite Care in Surprise, Arizona
NPI 1679647614

Gwendolyn Baker is a Child Mental Illness Respite Care based in Surprise, AZ and is specialized in Respite Care, Mental Illness, Child. Gwendolyn Baker practices in Surprise, AZ. The NPI Number for Gwendolyn Baker is 1679647614 and holds a License No. 1825 (Arizona).

The current practice location address for Gwendolyn Baker is 16640 W Rim Rock St, Surprise, AZ and can be reached out via phone at 623-594-9924. You can also correspond with Gwendolyn Baker through the mailing address at 16640 W RIM ROCK ST, SURPRISE, AZ - 85388-1193 (mailing address contact number: 623-594-9924).

Location: 16640 W Rim Rock St, Surprise, AZ, 85388-1193
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679647614
Provider Name
Gwendolyn Baker
Credential
Provider Entity Type
Individual
Gender
Female
Address
16640 W Rim Rock St, Surprise, AZ, 85388-1193
Phone Number
623-594-9924
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 823759
institution
Provider Business Practice Location Address Details
Address
16640 W Rim Rock St
City
Surprise
State
Arizona
Zip
85388-1193
Phone Number
623-594-9924
Fax Number
person
Provider Business Mailing Address Details
Address
16640 W Rim Rock St
City
Surprise
State
Arizona
Zip
85388-1193
Phone Number
623-594-9924
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.
1825 (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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