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Randy Bland
Child Mental Illness Respite Care in Goodyear, Arizona
NPI 1700423902

Randy Bland is a Child Mental Illness Respite Care based in Tucson, AZ and is specialized in Respite Care, Mental Illness, Child. Randy Bland practices in Goodyear, AZ. The NPI Number for Randy Bland is 1700423902 and holds a License No. 10126301 (Arizona).

The current practice location address for Randy Bland is 14047 W Monte Vista Rd, Goodyear, AZ and can be reached out via phone at 480-334-2092.

Location: 14047 W Monte Vista Rd, Goodyear, AZ, 85754-6537
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700423902
Provider Name
Randy Bland
Credential
Provider Entity Type
Individual
Gender
Male
Address
14047 W Monte Vista Rd, Goodyear, AZ, 85754-6537
Phone Number
480-334-2092
Fax Number
Provider Enumeration Date
12/06/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1700423902 01 AZ THERAPEUTIC FOSTER CARE
10126301 01 AZ AZ DEPT OF HEALTH SERVICES
institution
Provider Business Practice Location Address Details
Address
14047 W Monte Vista Rd
City
Goodyear
State
Arizona
Zip
85395
Phone Number
480-334-2092
Fax Number
person
Provider Business Mailing Address Details
Address
14047 W Monte Vista Rd
City
Goodyear
State
Arizona
Zip
85395
Phone Number
480-334-2092
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.
10126301 (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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