Country Care Residential Services LLC

NPI #1285320812 in Tolleson, Arizona

Provider Information

NPI Number: 1285320812
Entity Type: Organization
Organization Name: Country Care Residential Services LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 17, 2023
Last Updated: Apr 17, 2023

Practice Location

Address: 3241 S 93RD DR
City: Tolleson
State: Arizona
ZIP Code: 85353-5536
Phone: (623) 600-8863

Authorized Official

Name: MR. JUDITH OYUO
Title: ADMINISTRATOR
Phone: (623) 600-8863

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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